Comparison of femorofemoral and aortofemoral bypass for aortoiliac occlusive disease.
BACKGROUND
Role and results of femorofemoral bypass grafting, usually reserved to high-risk patients affected with unilateral iliac artery occlusion, are still debated.


METHODS



METHODS
retrospective clinical study.


METHODS
University Hospital.


METHODS
seventy-six high-risk patients (group 1) who underwent a primary expanded polytetrafluoroethylene (ePTFE) externally supported femorofemoral bypass graft were retrospectively compared to two additional groups of patients selected from the entire series of patients who underwent an aortobifemoral bypass graft. Patients of group 2 (n=80) were randomly chosen to determine differences in risk factors, associated diseases, previous abdominal operations, operative indications, preoperative findings and outcome. Patients of group 3 (n=50) were matched for sex, risk factors, associated diseases, previous abdominal operations, operative indications and preoperative findings with those of group 1 to assess the importance of the type of operation in determining the outcome of the procedure.


RESULTS
Postoperative mortality (6, 4 and 6%, respectively), 5-year primary and secondary patency (71, 80, 83% and 80, 87, 87%, respectively) and limb salvage rates (78, 87 and 87%, respectively) were similar among the groups (p=NS, p=NS, p=NS, respectively). Five-year survival rate of group 2 was significantly better than that of group 1 and 3 (p<0.04 and p<0.04, respectively).


CONCLUSIONS
Primary ePTFE externally supported femorofemoral bypass graft in high-risk patients is safe and produces long-term results similar to aortofemoral reconstruction.
Mingoli
A
A
Department of Surgery, Creighton University, Omaha, NE, USA.
Sapienza
P
P
Feldhaus
R J
RJ
Di Marzo
L
L
Burchi
C
C
Cavallaro
A
A
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000401:mortality / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene