Femorofemoral bypass for unilateral iliac artery occlusion in the presence of bilateral superficial femoral artery occlusions.
The femorofemoral bypass has become a popular technique of reconstruction for unilateral iliac artery occlusion because of low morbidity and excellent long-term patency. A "steal phenomenon" is infrequently seen, but even in relatively sedentary patients with limb-threatening ischemia femorofemoral grafting has been associated with severe donor limb ischemia in occasional instances. This report describes five high risk elderly patients who underwent femorofemoral bypass for limb-threatening ischemia due to unilateral iliac artery occlusion in association with bilateral superficial femoral artery occlusions. All patients underwent successful bypass as judged by relief of rest pain and healing of ulcerations. Despite a pre-operative resting donor limb mean ankle/brachial index of .45, there was no deterioration of donor limb perfusion when patients were followed for a mean of 15.6 months. It is concluded that femorofemoral bypass is the procedure of choice for limb salvage in poor risk patients with adequate donor limb inflow regardless of the degree of outflow occlusive disease.
Todd
G J
GJ
Voorhees
A B
AB
Nowygrod
R
R
Reemtsma
K
K
D000368:Aged; D000698:Analgesia; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D004452:Echocardiography; D004691:Endarterectomy; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery; D007871:Leg Ulcer / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D013526:Surgical Mesh
D011093:Polyethylene Terephthalates