The role of cross-over bypass graft in the treatment of acute ischaemia of the lower limb.
BACKGROUND
The Authors reports their experience with the use of femoro-femoral cross-over bypass graft in the management of acute lower limb ischaemia.


METHODS
Fourteen femoro-femoral bypass graft were performed for acute lower limb ischaemia due to unilateral thrombosis of iliac and femoral artery in 8 cases, late unilateral occlusion of a branch of previous aortobifemoral bypass in 3 cases, acute thrombosis of abdominal aorta in 2 cases and in the last one for an injury of common iliac artery during urological procedure. In all the cases the operations were carried out under local anaesthesia and a subcutaneous bypass with 'C' shape type configuration with 8 mm Dacron prosthesis were performed. The first and second year primary and secondary patency rates and limb salvage rates were evaluated.


RESULTS
One and two year patency rate was 83.3 (10/12) and 70% (7/10) respectively. Secondary patency rate and limb salvage rate was 91.6% (11/12) and 80% (8/10) respectively. A tight amputation had to performed in 3 failed reconstruction (3/12, 25%). Two patient died within 30 days after surgery from acute myocardial infarct. In 1 case infection occurred and re-do femorofemoral cross-over bypass with saphenous vein was carried out (8.3%).


CONCLUSIONS
Cross-over bypass is an attractive technique, especially in case of acute ischemia because of its simplicity, low morbidity and mortality, and good long term results.
Marcucci
G
G
S. Paolo Hospital, Civitavecchia, Division of Vascular and Endovascular Surgery, Roma, Italy.
Antonelli
R
R
Accrocca
F
F
Siani
L M
LM
Giordano
G A
GA
Baldassarre
E
E
Mounayergi
F
F
Siani
A
A
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014656:Vascular Surgical Procedures / Q000379:methods