Thirteen patients who underwent aorto-bifemoral bypass (A-F), 12 who had femoro-femoral bypass (F-F), and 8 who had axillo-femoral bypass (Ax-F) were evaluated to compare the hemodynamic improvement of the individual proce dures by recording mean preoperative and postoperative ankle/arm pressure index (API) in symptomatic extremities..
Hemodynamic improvement as measured by API was the same for A-F, F-F, Ax- F. A decision about whether A-F, F-F, or Ax-F would be appropriate should be made by considerations other than the expected immediate hemodynamic bene fit, for there is no statistically significant difference in the hemodynamic im provement among these three common bypass procedures.
Get full access to this article
View all access options for this article.
References
1.
Brief DK, Alpert J., Parsonnet V.: Crossover femoro-femoral grafts; compromise or preference: A reappraisal. Arch Surg105:889, 1972.
2.
Livesay JJ, Atkinson JB, Baker JD, et al: Late results of extraanatomical bypass. Arch Surg114:1260, 1979.
3.
Mannick JA, Williams LE, Nabseth DC: The late results of axillo-femoral grafts. Surgery68:1038, 1970.
4.
O'Donnell TF Jr, Lahey SJ, Kelly JJ, et al: A prospective study of Doppler pressure and segmental plethysmography before and following aorto-femoral bypass. Surgery86:120, 1979.
5.
Dunn D., Downs AR, Lye CR: Aortoiliac reconstruction for occlusive disease: Comparison of end-to-end and end-to-side proximal anastomosis. ConnJ Surg25:382, 1982.
6.
Mannick JA: In: Vascular Surgery—A Comprehensive Review, ed. by Moore WS.Orlando, Fla.: Grune and Stratton, 1983.
7.
DeLaurentis DA, Sala LE, Russel E., et al: A twelve-year experience with axillo-femoral and femoro-femoral bypass operations. Surg Gynecol Obstet147:881, 1978.
8.
Yao Jst: Haemodynamic studies in peripheral arterial disease. Br J Surg57:761, 1970.
9.
Raines JK, Darling RC, Both J., et al: Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. Surgery79:21, 1976.
10.
Ehrenfeld WK , Harris JP, Wylie EJ: Vascular "steal" phenomenon; an experimental study. Am J Surg116:192, 1968.
11.
Flanigan DP, Yao Jst, Bergan J.: Crossover femoro-femoral grafting in patients with severe lower extremity ischemia. In: Gangrene and Severe Ischemia of the Lower Extremities , ed. by Bergan JJ, Yao JST, New York: Grune and Stratton , 1978, p 209.
12.
Sumner DA, Strandness DE Jr: The hemodynamics of the femoro-femoral shunt. Surg Gynecol Obstet134:629, 1972.
13.
Hartman AR, Fried KS, Khalil I., et al: Late axillary artery thrombosis in patients with occluded axillary-femoral bypass grafts. J Vasc Surg2:285, 1985.
