Role of crossover bypasses in the treatment of ischemia of the lower extremity.
OBJECTIVE
To evaluate the role of crossover bypasses in the treatment of the lower extremity ischemia.


METHODS
A retrospective study (1978-1997) included 51 patients with 52 femoro- or iliofemoral crossover bypasses. The most frequent indication for crossover bypass was unilateral thrombotic occlusion of the bifurcated graft or unilateral pelvic occlusion (49.0%) and the rest pain (40.4%). The main type of crossover reconstruction was "U" shaped, subcutaneous femorofemoral bypass. The first, third, and fifth year primary patency rates were evaluated using the life table analysis method.


RESULTS
The cumulative patency rates were 91.3%, 73.9%, and 54.5% at 1, 3, and 5 years, respectively. Limb amputation had to be performed in five (9.6%) failed reconstructions. In four (7.7%) cases, thrombosis of reconstruction, and in one (1.9%) case, graft infection, caused the bypass occlusion. One patient (1.9%) died within 30 days after surgery from an acute myocardial attack.


CONCLUSIONS
Crossover bypass is an attractive method because of its technical simplicity, low morbidity, and good long-term results.
Treska
V
V
Chirurgicka klinika FN, ul. Dr. E. Benese 13, 305 99 Plzen, The Czech Republic. TRESKA@fnplzen.cz
Valenta
J
J
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007511:Ischemia / Q000175:diagnosis / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000379:methods*