title: The crossover femoropopliteal bypass: a useful option for unilaterial iliofemoral occlusive disease.
abstract: OBJECTIVE
  To study the outcome of treating critical limb ischaemia due to concurrent, unilateral iliac and femoral arterial occlusive disease by the placement of a crossover femoropopliteal bypass graft.
  
  
  METHODS
  Retrospective study of 10 patients unfit for aortic reconstruction whose disease was not amenable to endovascular therapy who were treated with this graft.
  
  
  METHODS
  Seven grafts originated from the common femoral artery, two from aortobifemoral graft limbs and one from the common iliac artery. There was not direct revascularisation of the profunda femoris artery. The distal anastomosis was to the above-knee popliteal artery in nine cases and to the below-knee popliteal artery in one.
  
  
  METHODS
  Follow-up after discharge from hospital consisted of regular ankle-brachial index measurement and Duplex ultrasound scan assessment to record graft patency and limb salvage.
  
  
  RESULTS
  The median duration of secondary patency was 52.5 months (range 14-84). During follow-up, there were four occlusive events. One graft had its patency restored, but in the other three patients, graft occlusion was associated with limb loss (at 18, 51 and 83 months respectively). In one of this latter group, surveillance had identified a failing graft and a jump graft prolonged patency for a further 34 months.
  
  
  CONCLUSIONS
  This experience demonstrates that the crossover femoropopliteal bypass achieves satisfactory limb salvage in patients with extensive iliofemoral occlusive disease who are not suitable for major aortic reconstruction.
authors.affiliation: Vascular Surgery Unit, Royal Infirmary, Edinburgh, U.K.
authors.forename: R T
authors.initials: RT
authors.lastname: Chalmers
authors.forename: J
authors.initials: J
authors.lastname: Kerr
authors.forename: T
authors.initials: T
authors.lastname: Gillies
authors.forename: J
authors.initials: J
authors.lastname: Brittenden
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D011138:Polytetrafluoroethylene