Bypass from the descending thoracic aorta to the femoral arteries is well described but infrequently used as a method of revascularization for lower extremity ischemia caused by aortoiliac occlusive disease. Descending thoracic aorta to femoral artery bypass has been traditionally used as a remedial operation after aortic or axillofemoral graft failure or graft infection or when a direct aortic approach is not possible. An expanded role for descending thoracic aorta to femoral artery bypass for primary revascularization in the presence of severe calcified atherosclerotic disease or complete occlusion of the infrarenal aorta should also be considered. This chapter reviews the historical background, operative technique, surgical indications, and clinical results of the operation.
Freeman NE, Leeds FHOperations on large arteries: Applications of recent advances. Calif Med1952;77:229-233
2.
Lewis CDA subclavian artery as the means of blood-supply to the lower half of the body. Br J Surg1961,48:574-575
3.
Stevenson JK , Sauvage LR, Harkins HNA bypass homograft from thoracic aorta to femoral arteries for occlusive vascular disease. Am Surg1961;27:632-637
4.
Blaisdell FWExtraperitoneal thoracic aorta to femoral bypass . Am J Surg1961; 102:83-85
5.
Vetto RMThe treatment of unilateral iliac artery obstruction with a transabdominal, subcutaneous femorofemoral graft. Surgery1962;52:342-345
6.
Blaisdell FW , Hall ADAxillary-femoral artery bypass for lower extremity ischemia. Surgery1963;54:563-568
7.
Louw JHSplenic-to-femoral and axillary-to-femoral bypass grafts in diffuse atherosclerotic occlusive disease. Lancet1963;29:1401-1402
8.
Sauvage LR, Wood SJUnilateral axillary bilateral femoral bifurcation graft: A procedure for the poor risk patient with aortoiliac disease. Surgery1966;60:573-577
9.
Nunn DB, Kamal MA, Bypass grafting from the thoracic aorta to femoral arteries for high aortoiliac occlusive disease. Surgery1972 ;72(5):749-755
10.
Froysaker T. , Skagseth E., Dundas P., et al. Bypass procedures in the treatment of obstructions of the abdominal aorta. J Cardiovasc Surg1973;14:317-321
11.
Buxton B., Simpson L., Johnson N., et al. Descending thoracic aortofemoral bypass for distal aortic reconstruction after removal of an infected dacron prosthesis. Med J Aust1976; 2:133-136
12.
Lakner G., Lukacs L.High aortoiliac occlusion: Treatment with thoracic aorta to femoral arterial bypass. J Cardiovasc Surg1983;24:532-534
13.
Haas K., Moulder PV, Kerstein MDUse of thoracic aortobifemoral artery bypass grafting as an alternative procedure for occlusive aortoiliac disease. Am Surg1985;51(10):573-576
14.
Schellack J. , Fulenwider T., Smith RBDescending thoracic aortofemoral-femoral bypass: A remedial alternative for the failed aortobifemoral bypass. J Cardiovasc Surg1988; 29:201-204
15.
Bradham RR, Locklair PR Jr,Grimball A.Descending thoracic aorta to femoral artery bypass. J S C Med Assoc1989;85:283-286
16.
O'Brien DP, Waldron RP, McCabe JP, et al. Descending thoracic aorto-bifemoral bypass graft: A safe alternative in high risk patients. Irish Med J1991;84(2):58-59
Reilly LM, Ehrenfeld WK, Stoney RJDelayed aortic prosthetic reconstruction after removal of an infected graft . Am J Surg1984;148:234-239
19.
Bowes DE, Keagy BA, Benoit CH, et al. Descending thoracic aortobifemoral bypass for occluded abdominal aorta: Retroperitoneal route without an abdominal incision. J Cardiovasc Surg1985;26:41-45
20.
Kalman PG, Johnston KW, Walker PMDescending thoracic aortofemoral bypass as an alternative for aortoiliac revascularization . J Cardiovasc Surg1991 ;32:443-446
21.
Hussain SADescending thoracic aorta to bifemoral by-pass graft without laparotomy . Int Surg1988;73:260-263
22.
Feldhaus RJ , Sterpetti AV, Shultz RD, et al. Thoracic aorta-femoral bypass: Indications, technique, and late results. Ann Thorac Surg1985;40(6):588-592
23.
Bowes DE, Youkey JR, Pharr WP, et al. Long term follow-up of descending thoracic aorto-iliac/femoral bypass. J Cardiovasc Surg1990;31:430-437
24.
Criado E., Johnson G. Jr, Burnham SJ, et al. Descending thoracic aorta-to-iliofemoral artery bypass as an alternative to aortoiliac reconstruction. J Vasc Surg1992;15:550-557
25.
Branchereau A., Magnan PE, Moracchini P., et al. Use of descending thoracic aorta for lower limb revascularization. Eur J Vasc1992 ;6:255-262
26.
McCarthy WJ , Mesh CL, McMillan WD, et al. Descending thoracic aorta-to-femoral artery bypass: Ten years' experience with a durable procedure. J Vasc Surg1993;17:336-348
27.
Criado E., Keagy BAUse of the descending thoracic aorta as an inflow source in aortoiliac reconstruction: Indications and long-term results. Ann Vase Surg1994;8:38-47
28.
Sapienza P., Mingoli A., Feldhaus RJ, et al. Descending thoracic aorta-to-femoral artery bypass grafts. Am J Surg1997;174:662-666
29.
Passman MA, Farber MA, Criado E., et al. Descending thoracic aorta to iliofemoral artery bypass: A role for primary revascularization for aortoiliac occlusive disease? J Vasc Surg1999;29:249-258
30.
Ligush J. Jr, Criado E., Burnham SJ, et al. Management and outcome of chronic atherosclerotic infrarenal aortic occlusion. J Vasc Surg1996;24:394-405
31.
Criado E., Keagy BADescending thoracic aorta to femoral artery bypass. Contemp Surg1991;39:15-19
32.
Frazier OH, Oalmann MC, Strong JP, et al. Clinical applications of the supraceliac aorta: Anatomic and pathologic observations. J Thorac Cardiovasc Surg1987;93:631-633
33.
Bernhard VM , Ray LI, Towne JBThe reoperation of choice for aortofemoral graft occlusion. Surgery1977;82(6)867-874
34.
Fulenwider JT, Smith RB, Johnson RW, et al. Reoperative abdominal arterial surgery-a ten-year experience. Surgery1983;93(1):20-27
35.
Benhamou AC , Kieffer E., Tricot JF, et al. "Redo" surgery for late aort-femoral graft occlusive failures. J Cardiovasc Surg1984;25(2):118-125
36.
Brewster DC , Meier GH, Darling RC, et al. Reoperation for aortofemoral graft limb occlusion: Optimal methods and long-term results . J Vasc Surg1987;5:363-374
37.
Naylor AR, Ah-See AK, Engeset J.Graft occlusion following aortofemoral bypass for peripheral ischemia . Br J Surg1989;76(6):572-575
38.
Haiart DC, Callam MJ, Murie JA, et al. Reoperations for late complication following abdominal aortic operation. Br J Surg1991;78(2):204-206
39.
Moore WA, Hall AD, Blaisdell FWLate results of axillary-femoral bypass grafting. Am J Surg1971;122:148-154
40.
LoGerfo FW, Johnson W., Corson JD, et al. A comparison of the late patency rates of axillobilateral femoral and axillounilateral femoral grafts. Surgery1977;81:33-40
41.
Ray LI, O'Conner JB, Davis CC, et al. Axillofemoral bypass: A critical appraisal of its role in the management of aortoiliac occlusive disease. Am J Surg1979;138:117-128
42.
Burrell MJ, Wheeler JR, Gregory RT, et al. Axillofemoral bypass: A ten year review. Ann Surg1982;195:796-799
43.
El-Massry S. , Saad E., Sauvage LR, et al. Axillofemoral bypass with externally supported, knitted Dacron grafts: A follow-up through twelve years . J Vasc Surg1990;12:416-421
44.
Passman MA, Taylor LM Jr, Moneta GL, et al. Comparison of axillofemoral and aortofemoral bypass for aortoiliac occlusive disease. J Vasc Surg1996;23:263-271
45.
Malone JM, Goldstone J., Moore WSThe natural history of bilateral aortofemoral bypass grafts for ischemia of the lower extremities. Arch Surg1975;110:1300-1306
46.
Nevelsteen A., Suy R., Daenen W., Et al. Aortofemoral grafting: Factors influencing late results. Surgery1980;88:642-653
47.
Crawford ES , Bomberger RA, Glaeser DH, et al. Aortoiliac occlusive disease: Factors influencing survival and function following reconstructive operation over a twenty-five year period. Surgery1981;90:1055-1067
48.
Szilagyi DE , Elliot JP Jr, Smith RF, et al. A thirty-year survey of the reconstructive surgical treatment of aortoiliac occlusive disease . J Vasc Surg1986;3:421-436
49.
Brewster DCCurrent controversies in the management of aortoiliac occlusive disease. J Vasc Surg1997;25:365-379
50.
Liddicoat JE , Bekassy SM, Dang MG, et al. Complete occlusion of the infrarenal abdominal aorta: Management and results in 64 patients. Surgery1975;77:467-472
51.
Traverso LW , Baker JD, Dainko EA, et al. Infrarenal aortic occlusion. Ann Surg1978; 187:397-401
