Patency rates of femorofemoral bypasses associated with endovascular aneurysm repair surpass those performed for occlusive disease.
OBJECTIVE
To evaluate the patency rates of femorofemoral grafts performed in conjunction with aortomonoiliac or aortomonofemoral (AMI/F) endografts.


METHODS
Over the past 8 years, 110 patients (98 men; mean age 77+/-7 years, range 57-90) underwent aortoiliac aneurysm repair with an AMI/F endograft. Follow-up data in these patients were prospectively collected for a mean 2.3 years (range 1-68 months).


RESULTS
There were 2 early (<7 days) AMI/F endograft thromboses with secondary femorofemoral graft occlusion. In both patients, patency of all grafts was restored by thrombectomy plus stenting of the endograft. Three late (4, 5, and 10 months) AMI/F endograft thromboses led to femorofemoral graft failure; 2 were successfully treated, but the third patient refused further intervention. No femorofemoral bypass failed in the absence of AMI/F endograft thrombosis. There were no femorofemoral graft infections. Four-year life-table primary and secondary patency rates were 95% and 99%, respectively.


CONCLUSIONS
Femorofemoral bypasses with AMI/F endografts for aneurysmal disease are durable procedures and have better patency than femorofemoral grafts used to treat occlusive disease. Femorofemoral bypass patency rates alone are not a disadvantage of aortomonoiliac endografts.
Lipsitz
Evan C
EC
Division of Vascular Surgery, Department of Surgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York 10467, USA. Elipsitz@aol.com
Ohki
Takao
T
Veith
Frank J
FJ
Rhee
Soo J
SJ
Gargiulo
Nicholas J
NJ
Suggs
William D
WD
Wain
Reese A
RA
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014656:Vascular Surgical Procedures / Q000379:methods / Q000401:mortality