Radsportler mit Claudicatio nach aorto-iliakaler Y-Prothese

Summary Sport cyclist presenting claudication after aortoiliac y-graft We present the case of a 38-year-old athlete with Erdheim-Gsell medial necro- sis who presented claudication one year after implantation of an aortobiiliac y-graft for spontaneous infrarenal aortic dissection. The tests performed revealed a discrepancy between the diameter of the aortoiliac graft and the native arteries. To evaluate the functional result after aortoiliac grafting we used magnetic res- onance imaging (MRI) to measure blood flow at rest and the maximum increase during hyperemia after release of a tourniquet. Results were compared with those from three healthy volunteers. MRI revealed a lower flow reserve at reactive hyperemia in our patient com- pared to the healthy volunteers. After reoperation for implantation of a tho- raco-external-iliac (left side)/-femoral (right side) y-graft the patient became asymptomatic. MRI showed little difference in flow reserve but greater total flow at rest and during hyperemia. Comparison of postoperative flow during reactive hyperemia with the preoperative baseline value showed a flow reserve exceeding that of the healthy volunteers. We present a simple and reproducible method of measuring arterial flow reserve using MRI to evaluate not only anatomy but also arterial function.