Femorofemoral Bypass: An Analysis of 53 Femorofemoral Grafts

Abstract

The indications, complications, mortality, and patency rates of 53 femorofemoral (F-F) bypass grafts during a 10-year period were analyzed. Forty-two of the 53 (79%) procedures were for atherosclerotic disease (Group I): 16 (38%) F-F grafts alone, nine (21%) with iliac artery balloon angioplasty (IABA), 13 (31%) with femorodistal (F-D) bypass, and four (10%) with both IABA and F-D bypass. Eleven of the 53 (21%) patients with acute ischemia were treated with F-F grafts alone after intraaortic balloon pumping (IABP) (Group II). Two (4%) occlusions occurred within 30 days in F-F grafts performed with F-D grafts, and seven (13%) occluded late. The cumulative patency rate for F-F grafts alone was 72% at 5 years and 59% at 10 years, and for F-F grafts with additional procedures was 24% at 5 years and 14% at 10 years. Total cumulative patency rate for 5 years was 60%. The 30-day mortality rate was 6%; the 5-year mortality rate was 17% (9/53), and the cumulative 10-year mortality rate was 42% (22/53).

Get full access to this article

View all access options for this article.

References

1. Nolan KD , Benjamin ME , Murphy TJ , et al: Femoro-femoral bypass for aortofemoral graft limb occlusion: A ten-year experience. J Vasc Surg 19:851-857, 1994.

2. Lorenzi G , Domanin M , Costantini A , et al: Role of bypass, endarterectomy, extraanatomic bypass and endovascular surgery in unilateral iliac occlusive disease: A review of 1,257 cases. Cardiovasc Surg 2:370-373, 1994.

3. Freeman NE , Leeds FH : Operations on large arteries. Calif Med 77:229-231, 1952.

4. Vetto RM : The treatment of unilateral iliac artery obstruction utilizing femorofemoral graft. Surgery 52:342-345, 1962.

5. Porter MJ , Eidemiller RL , Dotter TC , et al: Combined arterial dilatation and femorofemoral bypass for limb salvage. Surg Gynecol Obstet 137:409-412, 1973.

6. Brouwer JHM , Biemans MCR , Donders CPH : Longterm results of 44 crossover bypasses. J Cardiovasc Surg 29:290-295, 1988.

7. Raithel D : The femorofemoral bypass graft: An analysis of 81 femorofemoral grafts. Vascular Surgery 14:73-77, 1980.

8. Mosley GJ , Marston A : Long-term results of 66 femoral to femoral bypass grafts: A 9-year follow-up. Br J Surg 70:631-634, 1983.

9. Fahal HA , McDonald MA , Marston A : Femorofemoral bypass in unilateral iliac artery occlusion. Br J Surg 76:22-25, 1989.

10.

10. Mannick AJ , Maini SB : Femorofemoral grafting: Indications and late results. Am J Surg 136:190-192, 1976.

11.

11. Lamerton JA , Nicolaides NA , Eastcott GHH : The femorofemoral graft. Arch Surg 120:1274-1278, 1985.

12.

12. Dick SL , Brief KD , Alpert J , et al: A 12-year experience with femorofemoral crossover grafts. Arch Surg 115:1359-1365, 1980.

13.

13. Wilson ES , White HG , Wolf G , et al: Proximal percutaneous balloon angioplasty and distal bypass for multilevel arterial occlusion. Ann Vasc Surg 4:351-355, 1990.