Juxtarenal Aortoiliac Occlusive Disease in a Patient With Left Sided Inferior Vena Cava

A 58-year-old patient presented with critical ischemia of the right lower limb. CT angiography showed bilateral aortoiliac occlusive disease from the juxtarenal region and a left inferior vena cava (LIVC) that crossed to the right side in front of the aorta at the juxtarenal level (Fig. 1).

Fig. 1

Using midline laparotomy, an aortobifemoral bypass was performed with a Dacron^® 14 × 7 × 7 mm bypass graft, requiring mobilization of the LIVC to allow for suprarenal clamping and the creation of a proximal end-to-end anastomoses (Fig. 2).

Fig. 2

The patient recovered bilateral pedal pulse and experienced transient acute renal failure in the postoperative period. The patient was discharged 7 days after the operation.