title: The role of cross-over bypass graft in the treatment of acute ischaemia of the lower limb.
abstract: 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.
authors.affiliation: S. Paolo Hospital, Civitavecchia, Division of Vascular and Endovascular Surgery, Roma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Marcucci
authors.forename: R
authors.initials: R
authors.lastname: Antonelli
authors.forename: F
authors.initials: F
authors.lastname: Accrocca
authors.forename: L M
authors.initials: LM
authors.lastname: Siani
authors.forename: G A
authors.initials: GA
authors.lastname: Giordano
authors.forename: E
authors.initials: E
authors.lastname: Baldassarre
authors.forename: F
authors.initials: F
authors.lastname: Mounayergi
authors.forename: A
authors.initials: A
authors.lastname: Siani
mesh_terms: 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