The specimen is part of an aortic graft at the bifurcation. The right limb is stenosed and obstructed by organising thrombus. The stenosis was found to be caused by an external fibrous band occurring as a complication of the surgery; the thrombotic obstruction followed.
In 1974 this woman presented at the age of 36 with an 18 month history of bilateral intermittent claudication. There were no peripheral pulses in the lower limbs. The aorta between the origin of the inferior mesenteric artery and the bifurcation was narrowed by atheroma with superimposed organising thrombus. Her triglycerides were elevated as was the pre beta lipoprotein. At operation the right common iliac artery was found to be totally occluded and the left common iliac artery showed severe atheroma. A 12mm Dacron graft bypass was taken from the aorta to the two femoral arteries. In 1984 she had a recurrence of symptoms and at operation an external stenosis produced by fibrous tissue across the origin of the right limb of the graft was demonstrated. The graft was removed and replaced by a second graft.