Minimally Invasive Thoracoscopic Thoraco-Femoral Bypass: A Case Report

Recently investigators have reported preliminary experiences with minimally invasive techniques to treat aortoiliac occlusion and have suggested that these techniques may allow for better patient recovery as compared to traditional open surgery [1, 2). In each case, a limiting factor has been sufficient retraction of the viscera to allow for adequate exposure of the abdominal aorta. The authors' hypothesized that the thoracic cavity, with the rigid chest wall and relative paucity of mobile structures, would allow for a simplified endoscopic approach to the aorta. In fact, the descending thoracic aorta is rarely calcified and has been used successfully as an alternative source of inflow for 40 years. Published patency rates of thoraco-femoral bypass equal or exceed those of traditional aorto-bifemoral bypass [3-5). Herein, the first thoracoscopically-assisted thoraco-femoral bypass is reported.