From 1976 to 1981, 48 consecutive patients underwent femoro-femoral cross-over by-pass utilizing PTFE grafts. Indications were severe ischemia (69%) and claudication (31%). All were high-risk patients. Hemodynamic changes (ankle/brachial pressure index) and graft patency was studied during the first postop year.
No operative mortality was noticed. Graft thrombosis occurred in 13 cases during follow-up. Successful thrombectomy was done in 7 cases. Graft patency was 80% after 5 years in claudicants and 81% in severe ischemia. The limb salvage rate was 70% at 6 years follow-up. The walking distance increased sig nificantly during the 1st year. There was a good correlation between angiografi cally determined run-off and the ankle/brachial pressure index. In claudicants distal pressure index increased significantly from 0.38 to 0.60, 3 months postop in recipient leg. The same was true in severe ischemia, from 0,10 to 0.48, 3 months postop. No steel phenomena were observed. This procedure is useful for revascularization of a limb with occlusion of the iliac artery, with high graft patency and limb salvage rates and low morbidity and mortality. Even though ankle/brachial pressure index never is restored to normal a gradual increase is observed up to one year after operation. No adverse effects have been demon strated following the procedure. Patients have to be carefully selected for the procedure by preop angiography and hemodynamic evaluation.
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