Extrinsic band as an unusual cause of an intermittent graft obstruction

Graft failure is a common complication of vascular bypass. Most grafts failures are secondary to neo-intimal hyperplasia at anastomotic sites, progression of the atherosclerotic disease in distal arteries or mechanical failure of the conduit itself, mainly manifested at the early postoperative period. Late arterial-bypass obstruction by an external fibrotic band has not been previously described, according to our knowledge. Recently, we have encountered an arterial bypass (reversed saphenous vein graft) obstructed by an extrinsic band causing intermittent flow obstruction, manifested as typical intermittent claudication at short distance.