Aortofemoral Bypass Grafting

Jones, Arthur F.; Kempczinski, Richard F.

doi:10.1001/archsurg.1981.01380150029007

Cited by 28 publications

(6 citation statements)

References 11 publications

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“…26 Jones and Kempczinski, in their study of 100 patients with aortobifemoral bypasses, described an early patency rate of 100% if the superficial femoral artery was patent and 83% if it was occluded. 27 In the same study, the late patency rate was 89% and 70%, respectively. Poulias and colleagues published the results of 500 cases with aortobifemoral bypasses operated on during a 14-year period.…”

Section: Discussionmentioning

confidence: 80%

Aortobifemoral Grafting: Factors Influencing Long-Term Results

et al. 2004

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We present the results and respective determinant factors of 283 consecutive aortobifemoral bypasses. This prospective study included 283 patients with aortoiliac atherosclerotic occlusive disease treated by aortobifemoral reconstructions. Polytetrafluoroethylene (PTFE) grafts were used in 136 patients and Dacron grafts in 147 patients. The 30-day mortality rate was 11 patients (3.9%). Perioperative (< 30 days) graft failure occurred in 6 patients (2.1%), whereas in 14 (5.25%) patients, it occurred during the follow-up period. There were 3 (1.05%) distal anastomotic pseudoaneurysms and 5 (1.7%) graft infections, with no statistical difference between the two types of grafts. The type of prosthesis did not influence cumulative graft patency. The end-to-end configuration of proximal anastomosis and a simultaneously performed femoropopliteal bypass significantly increased the graft patency (p < .05). The associated occlusion of the superficial femoral and popliteal arteries decreased the cumulative graft patency in comparison with that of the patients without artery disease (p < .05). Our results showed that in the aortobifemoral position, there was no significant difference in the patency, anastomotic pseudoaneurysms, and graft infection between PTFE and Dacron grafts. However, the PTFE grafts had a significantly higher rate (p < .05) of distal anastomotic stenosis, which was mostly caused by neointimal hyperplasia.

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Section: Discussionmentioning

confidence: 80%

Aortobifemoral Grafting: Factors Influencing Long-Term Results

et al. 2004

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“…This difference is positive and not significant in subgroup 3 (previous iliac axis and occluded femoral artery), with x2 p < 1 and 1 df in both cases. In subgroup 5 (previous iliac axis and occluded femoral), the variation between the preoperative API and that at forty-five minutes is positive and, though small, is statistically significant (X2 = 9.45, 1 df, p < 0.01 ) .…”

Section: Resultsmentioning

confidence: 76%

Study of Peripheral Flow During Successful Aortoiliac and Aortofemoral Prosthetic Reconstructions by Intraoperative Above-Ankle Pressure Index Monitoring

et al. 1990

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Doppler above-ankle pressure index (API) was monitored during 368 consecutive bilateral aortoiliac or aortofemoral graft reconstructions performed for aneurysmal or occlusive disease. The aim of this study was to investigate the variations of peripheral pressure, during and just after completion of the procedure, either when followed by immediate and definitive success or when an intraoperative correction or an early postoperative reoperation was necessary owing to postreconstructive ischemia. For this purpose the API courses were subdivided into three groups: A (705 limbs), which underwent immediately successful reconstructions; B (22 limbs), which needed intraoperative correction; C (9 limbs), which required early reoperation. All 736 limbs were studied individually as monolateral reconstructions and classified into six subgroups: 1, pervious iliac, pervious femoral artery; 2, occluded iliac, pervious femoral; 3, pervious iliac, stenotic femoral (i.e, stenosis > 75% of the superficial femoral artery); 4, occluded iliac, stenotic femoral; 5, pervious iliac, occluded femoral; 6, occluded iliac, occluded femoral. APIs were monitored before the operation at NATIONAL TAIWAN UNIV LIB on June 29, 2015 ves.sagepub.com Downloaded from 308 (PRE), at the completion of the distal anastomosis (DEC), and five, fifteen, thirty, and forty-five minutes after. Data were statistically analyzed by multivariate analysis in regards to 705 immediately successful limbs (group A) and by comparison of all corrected or reoperated cases (groups B and C) with the lower bound of the fifth centiles of group A.The results in group A show that: API-PRE is different in the six subgroups (p < 0.001); API-DEC is lower than API-PRE in the patent iliac artery subgroups (1,3, and 5) and higher than API-PRE in the occluded iliac artery subgroups (2,4, and 6) (p always < 0.001). From declamping time to the forty-fiveminutes observation, the mean courses turn out parallel and rising but on different levels (p < 0.001): pervious femoral, stenotic femoral, occluded femoral. API-forty-five minutes is higher than API-PRE in occluded iliac artery subgroups (2, 4, and 6) (p < 0.001), whereas in the patent iliac artery subgroups only the fifth subgroups reveals a slight but significant rise (p < 0.01), probably owing to the high rate of profunda femoral endarterectomy or angioplasty associated with aortofemoral reconstructions.APIs values of 31 cases in groups B and C, compared with the lower bound of the fifth centile of group A, show that 8/31 cases (26%) remain above that bound, while 23/31 cases (74%) fall below it.

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“…Thanks to its low mortality rate and its excellent long-term patency, direct revascularization is the procedure of choice for the majority of patients. 22,23 Nevertheless, the surgeon must sometimes turn to the alternative axillofemoral procedure to avoid laparotomy. The presence of intraabdominal disease (tumors, colostomies, or urostomies) or serious system diseases increasing the operative risk can contraindicate the use of an aortofemoral bypass.…”

Section: Discussionmentioning

confidence: 99%

A Twenty-Year Experience with Axillofemoral Bypass: Analysis of 63 Consecutive Cases

et al. 1991

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The results of 63 consecutive axillofemoral bypass grafts are presented. A computerized analysis of the data was performed according to the possible variables apt to influence the results of the reconstruction: different indications, stage of disease, previous reconstructions, presence of graft infection, unilateral or bilateral revascularization, iliac artery and runoff status, and graft caliber and material. A higher five-year graft patency rate was obtained with bypasses performed in poor-risk patients with occlusive arterial disease (axillounifemoral graft: 53.7%; axillobifemoral graft: 41.6%) than in procedures performed in emergency (p < 0.025) or for infection of previous vascular reconstructions (p < 0.001). There was a similar five-year patency rate in axillounifemoral and axillobifemoral grafts (p = NS) and in the bypasses performed in patients with iliac artery occlusion or stenosis (p = NS). A higher patency rate was obtained when there were two or three patent tibial vessels (p < 0.001). Finally the authors observed a greater infection rate in polytetrafluoroethylene grafts than in Dacron grafts (p < 0.05). Their results confirm the important role of the axillofemoral bypass in revascularizing high-risk patients with severe limb ischemia (rest pain and necrosis) or patients with graft infection, repeated graft failures, and arterial occlusive disease when laparotomy is contraindicated.

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Aortofemoral Bypass Grafting

Cited by 28 publications

References 11 publications

Aortobifemoral Grafting: Factors Influencing Long-Term Results

Aortobifemoral Grafting: Factors Influencing Long-Term Results

Study of Peripheral Flow During Successful Aortoiliac and Aortofemoral Prosthetic Reconstructions by Intraoperative Above-Ankle Pressure Index Monitoring

A Twenty-Year Experience with Axillofemoral Bypass: Analysis of 63 Consecutive Cases

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