Extra-anatomic bypass operation for aorto-iliac disease in poor risk cardio-pulmonary patients.
Three years experience with subcutaneous axillo-femoral and bifemoral bypass surgical procedures has been outlined in patients with poor cardio-pulmonary and other risk related factors. Special emphasis has been made regarding technical consideration; advantages and disadvantages have been discussed. There were 49 limbs at risk in this group of 27 patients requiring axillo-bifemoral in 22, and axillo-unifemoral in 5. Sixty-three percent of patients had associated arteriosclerotic heart disease and 48% had severe emphysema. There were 3 peri-operative deaths for 11% hospital mortality and 3 late deaths (12.5%). Six of the remaining patients for whom long term follow-up is available, acute graft thrombosis occurred in 3 patients salvaged by graft thrombectomy and 4 patients had late thrombosis resulting in 3 permanent graft failures. Two patients required above the knee amputation. Limb salvage and relief of lower extremity ischemic pains has been gratifying. During the limited follow-up period from 1-36 months (Mean 18) there is 87% patency rate for 43 grafts to 43 limbs.
D000368:Aged; D000792:Angiography; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery*; D001161:Arteriosclerosis / Q000150:complications; D001366:Axillary Artery / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D048909:Diabetes Complications; D004285:Dogs; D004646:Emphysema / Q000150:complications; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009765:Obesity / Q000150:complications; D011660:Pulmonary Heart Disease; D012306:Risk