Extra-anatomical grafting for aorto-occlusive disease: the outcome in 133 procedures.
Between 1978 and 1988 133 extra-anatomical grafts were performed in patients presenting with aorto-iliac occlusive disease. These series include 50 cross-over grafts, 46 axillofemoral and 37 axillobifemoral grafts. The indication for operation was acute ischemia in 26.4%, claudication in 9.7% and limb salvage in 63.9% of cases. Perioperative mortality rate was 10.4%. The early patency rate decreased from 92% after cross-over grafting to 86% in the axillofemoral series and 8% of the patients needed a major amputation in the immediate postoperative period. With a mean follow-up of 32 months, 62% of the patients died within 5 years of the operation, 54% of deaths being due to cardiovascular complications. The 3-years patency rate decreased to 78% after cross-over grafting and 49% after axillofemoral grafting. The 3-year limb salvage rate decreased to 89% and 75% respectively. Although our results are definitely less favourable than those of direct aortofemoral grafting, they seem to support the further use of the cross-over graft in patients with unilateral occlusive disease. Axillofemoral grafting on the other hand should be preserved for limb saving reconstructions in high risk conditions.
Schroe
H
H
Department of Vascular Surgery, U.Z. Gasthuisberg, Leuven.
Nevelsteen
A
A
Suy
R
R
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001366:Axillary Artery / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000401:mortality; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014654:Vascular Patency