The risk of axillofemoral bypass grafting for acute vascular occlusion.
The hypothesis of the present study is that axillofemoral bypass grafting for acute vascular occlusion has results significantly inferior to an elective procedure. We reviewed 53 patients undergoing primary axillofemoral bypass grafting at the University of Virginia from 1984 to 1989. We found that patients who were admitted with acute vascular occlusion had a higher incidence of perioperative complications (63% vs 26%, p = 0.001), perioperative mortality (26% vs 3%, p less than 0.05), lower graft patency at 1 year (60% vs 90%, p less than 0.05), lower rate of freedom from reoperation in first year (50% vs 82%, p less than 0.01), and lower rates of limb salvage (76% vs 94%, p less than 0.05) than patients undergoing axillofemoral bypass grafting for chronic symptoms or conditions. These two groups did not differ in any of the other risk factors or perioperative characteristics examined. We conclude axillofemoral bypass grafting performed for indications other than acute vascular occlusion is associated with acceptable morbidity, mortality, graft patency, and limb salvage rates.
Agee
J M
JM
Department of Surgery, University of Virginia Medical Center, Charlottesville.
Kron
I L
IL
Flanagan
T
T
Tribble
C G
CG
D000208:Acute Disease; D000714:Anastomosis, Surgical / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D001366:Axillary Artery / Q000637:transplantation*; D002908:Chronic Disease; D005263:Femoral Artery / Q000637:transplantation*; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology / Q000401:mortality; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D014768:Virginia / Q000453:epidemiology