Axillofemoral grafting with externally supported polytetrafluoroethylene.
OBJECTIVE
To evaluate the results of axillofemoral bypass grafting using externally supported polytetrafluoroethylene.


METHODS
Consecutive patients who were operated on by us from 1983 to the present were prospectively followed up in a vascular registry. The results of surgery with respect to morbidity and mortality, patency, limb salvage, and patient survival were determined by life-table methods.


METHODS
A standardized operative technique was used to perform 184 axillofemoral bypass procedures in 164 consecutive patients (age range, 14 to 90 years; mean age, 67 years; female, 33%). Follow-up ranged from 0 to 95 months (mean, 23 months).


RESULTS
Ischemia was the indication for 83% of the procedures, and aortic sepsis was the indication for 16%. There were nine operative deaths (5%) and 17 major complications. Life-table primary patency, limb salvage, and survival rates at 5 years were 71%, 92%, and 52%, respectively. Indication for surgery, patency of the superficial femoral artery, and the performance of multilevel procedures did not significantly influence patency.


CONCLUSIONS
The results of axillofemoral grafting using polytetrafluoroethylene are equivalent to those achieved with other accepted methods of treatment for lower extremity ischemia, including balloon angioplasty, aortofemoral bypass, and infrainguinal bypass. Axillofemoral bypass is an appropriate technique that is deserving of more widespread use.
Taylor
L M
LM
Department of Surgery, Oregon Health Sciences University, Portland.
Moneta
G L
GL
McConnell
D
D
Yeager
R A
RA
Edwards
J M
JM
Porter
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001018:Aortic Diseases / Q000453:epidemiology / Q000601:surgery*; D001366:Axillary Artery / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D015897:Comorbidity; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007511:Ischemia / Q000453:epidemiology / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000601:surgery*; D016879:Salvage Therapy / Q000379:methods; D015996:Survival Rate; D014654:Vascular Patency
D011138:Polytetrafluoroethylene