Renal allograft dysfunction due to iliac artery occlusion: Cross-over femoro-femoral bypass saves the day

Isolated iliac artery stenosis or occlusion is a rare complication after renal transplantation. There are two treatment methods for suprarenal arterial stenosis, including percutaneous angioplasty with or without stents and surgical revascularization. Herein, we present a case of proximal common iliac artery stenosis with a patent renal artery who presented with hypertension and allograft dysfunction following transplantation and underwent cross-over femoro-femoral bypass. This case demonstrates that cross-over femoro-femoral bypass provides sufficient retrograde flow to perfuse renal allograft.