A 60-ish year-old client with a history of surgery for aortic aneurysm insists—INSISTS—that his 21-year-old massage therapist work with him, in spite of his new onset severe leg pain. What are the practitioner’s options in this literally life-or-death scenario? This story, that looks cut-and-dried on the surface, is more complex than it appears. Plus, we get to talk about bulges in the aorta, bleeding ruptures, migrating devices, new surgical innovations, and much much more. Listen in to find out how it all turns out. Resources: Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app Ameli, F.M. et al. (1987) ‘Etiology and management of aorto-femoral bypass graft failure’, The Journal of Cardiovascular Surgery, 28(6), pp. 695–700. Choi, E. et al. (2021) ‘Risk Factors for Early and Late Iliac Limb Occlusions of Stent Grafts Extending to the External Iliac Artery after Endovascular Abdominal Aneurysm Repair’, Annals of Vascular Surgery, 70, pp. 401–410. Available at: https://doi.org/10.1016/j.avsg.2020.06.028. Daye, D. and Walker, T.G. (2018) ‘Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management’, Cardiovascular Diagnosis and Therapy, 8(Suppl 1), pp. S138–S156. Available at: https://doi.org/10.21037/cdt.2017.09.17. Endovascular repair of complex aortic aneurysms - Mayo Clinic (no date). Available at: https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/endovascular-repair-of-complex-aortic-aneurysms/mac-20429867 (Accessed: 31 July 2024). Ivancev, K. and Vogelzang, R. (2020) ‘A 35 Year History of Stent Grafting, and How EVAR Conquered the World’, European Journal of Vascular and Endovascular Surgery, 59(5), pp. 685–694. Available at: https://doi.org/10.1016/j.ejvs.2020.03.017. Modern History of Aortic Surgery, by Hazim J. Safi, MD | McGovern Medical School (no date). Available at: https://med.uth.edu/cvs/2020/08/25/modern-history-of-aortic-surgery-by-hazim-j-safi-md/ (Accessed: 31 July 2024). Park, K.-M. et al. (2017) ‘Long Term Outcomes of Femorofemoral Crossover Bypass Grafts’, Vascular Specialist International, 33(2), pp. 55–58. Available at: https://doi.org/10.5758/vsi.2017.33.2.55. Sponsors: Anatomy Trains: www.anatomytrains.com  MassageBook: www.massagebook.com Elements Massage: www.elementsmassage.com/abmp