Extra-anatomical Obturator Bypass Due to Groin Infection

A rather common side effect of using prosthetic grafts is infection of the groin area. Infections in the groin may be avoided by performing arterial bypass  tenneling via the obturator foramen during lower extremity revascularization. This study aimed to evaluate the safety and efficacy of extra-anatomical bypass obturator in patients with groin infection.  

This cohort included a convenient sample of 100 patients with groin infections who planned to do an extra-anatomical obturator bypass. All patients were subjected to history taking and clinical assessment. Ultrasonography with duplex screening is a good initial technique to assess groin masses. Combination of computed tomography (CT) or magnetic resonance imaging (MRI) with indium-labeled leucocyte scintigraphy can also play a role in the diagnosis.  

Inflow from the already-existing graft limb was used in 54% of obturator canal bypass (OCB) procedures, with 32 limbs coming from the main iliac (27.3%) and 6 limbs from the infrarenal aorta (5.1%). The distal superficial femoral artery was used in 21 limbs (17.9%), while the above-knee popliteal artery was selected as the outflow artery in 82% of cases. Primary aided patency was 68% at 24 months, according to Kaplan-Meier analysis, whereas primary patency was 63% at that time. At 24 months, the secondary patency of the OCB was 83%.  

In case of groin infections, an excellent option to restore flow is an obturator bypass graft. This graft is strong, reliable, and safe. As a result of its high patency rate, it may be the first choice in certain circumstances.