Extra-anatomic bypass

An extra-anatomic bypass is the creation of a bypass whose pathway is normally devoid of a major arterial segment. Unlike conventional bypasses, the donor vessel is generally remote from and in line with the recipient vessel. These bypasses are commonly employed when a less physiologically stressful procedure is desirable in patients with limb ischemia with significant medical comorbidities, or in order to avoid working in an infected, or otherwise hostile, operative field. In the peripheral circulation, the most frequently performed configurations are the axillofemoral bypass and femorofemoral bypass. These configurations are most commonly used to revascularize occlusive atherosclerotic disease affecting the aortoiliac and femoral arteries. Other configurations, performed less frequently, include the obturator bypass and thoracofemoral bypass.