Between 1982 and 1986, 65 high-risk patients underwent iliofemoral cross over bypass (COBP) for unilateral iliac occlusion or stenosis; 53.8% complained of rest pain, 27.6% showed beginning gangrene, and 13.8% were operated on because of acute iliac occlusion. The proximal anastomosis was placed on the external iliac artery in 76.9%, the distal anastomosis on the profound femoral artery in 89.2%. The authors usually used PTFE grafts placed in the retrorec tal-preperitoneal space. Doppler index rose by 0.3, flow improvement averaged 3 mL/100 mg tis sue/min; no steal phenomenon was observed. Perioperative mortality was 7.6%, limb salvage rate was 93.4%. After a mean interval of 31.3 months, 31.6% had died, and 8 patients had had to undergo major amputations. Cumulative pat ency rate after one year was 81 %, after two years 71 %, and after three years 60%. The authors conclude that COBP is a valid alternative to anatomic iliac re construction in high-risk patients with unilateral iliac artery occlusion or steno sis.

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