RT Journal
A1 Perkins JB, Neistadt A, Feder FP
T1 SUprapubic vascular graft— a warning
JF JAMA
JO JAMA
YR 1969
FD March 3
VO 207
IS 9
SP 1718
OP 1718
DO 10.1001/jama.1969.03150220134031
UL http://dx.doi.org/10.1001/jama.1969.03150220134031
AB To the Editor:— 
    The femorofemoral bypass graft is an increasingly popular arterial shunt procedure. Such grafts traverse the suprapubic area subcutaneously and are therefore a potential hazard to the unsuspecting surgeon who may later undertake a lower abdominal, pelvic, or inguinal operation. A combined arteriogram and cystogram in one of our cases illustrates the relationship of graft and bladder (Fig 1).The subcutaneous interfemoral graft, described by Vetto1 in 1962, is used to relieve ischemia due to unilateral iliac arteriosclerosis obliterans. The technique is particularly valuable in poor-risk patients who cannot tolerate major abdominal surgery. The graft, a prothesis or vein, is simply introduced from one groin incision to the other by subcutaneous tunneling, then anastomosed to each common femoral artery. No warning suprapubic scar is visible. The scheme of the interfemoral graft is depicted in Fig 2.A history of prior arterial surgery or bilateral femoral scars should