Long Term Outcomes of Femorofemoral Crossover Bypass Grafts

Abstract

PurposeFemorofemoral crossover bypass (FCB) is a good procedure for patients with unilateral iliac artery disease. There are many articles about the results of FCB, but most of them were limited to 5 years follow-up. The purpose of our study was to analysis the results of FCB with a 10-year follow-up period.Materials and MethodsBetween January 1995 and December 2010, 133 patients were operated in Samsung Medical Center (median follow-up: 58.8 months). We retrospectively analysed patient characteristics, the preoperative treatment, the operative procedure, and material used.ResultsThe indications for FCB were claudication in 110 and critical limb ischemia in 23 patients. Three patients were died due to myocardiac infarction, intracranial hemorrhage, and acute respiratory failure within 30 days after surgery. The one-year primary and secondary patency rates were 89% and 97%, the 5-year primary and secondary patency rates were 70% and 85%, and the 10-year primary and secondary patency rates were 31% and 67%. The 5-year and 10-year limb salvage rates were 97% and 95%, respectively.ConclusionOur long term analysis suggests that FCB might be a valuable alternative treatment modality in patients with unilateral iliac artery disease.

Single-Center Experience on Extra-Anatomic Arterial Revascularisation Applications

“…Mortality rates were reported as 2 to 8% for thirty days and 23 to 73% for five years in axillo-femoral bypass series [10]. In femorofemoral bypass series the mortality rates were reported as 2.26% for 30 days and the causes of mortality were indicated as intracranial hemorrhage, acute respiratory failure and myocardial infarction [12]. Additionally primary patency rates were reported as 70% for five years and 31% for ten years [12].…”

“…In femorofemoral bypass series the mortality rates were reported as 2.26% for 30 days and the causes of mortality were indicated as intracranial hemorrhage, acute respiratory failure and myocardial infarction [12]. Additionally primary patency rates were reported as 70% for five years and 31% for ten years [12]. Although anatomical bypass has superior outcomes, the extra-anatomic procedures can applied for supplying distal blood flow in ischemic conditions that circumvent the "normal" anatomic pathways [13].…”

“…The higher incidence of amputation risk was reported in femoro-femoral bypass series, but previous reports identified as this can be related with disrupted distal vascular bed and long term poor blood supply to distal tissues. Moreover, the increased mortality rates can be related with abnormal anatomical bed presentation of selected patients for femoro-femoral bypass [12][13][14]. Appleton et al reported that patients with extra-anatomic bypass, who did not required amputation in first year, have more chance to long-term limb salvage [14].…”

Long-term outcomes of unilateral iliac stenting and femorofemoral crossover bypass for bilateral extensive iliac disease

“…In the literature, for unilateral iliac disease, FFB has both good short and long results; [5] however, in practice, iliac disease is usually more extensive rather than focal, involving both the iliac orifices in most of cases. It may compromises the patency of FFB.…”

Effectiveness of biological prosthesis for femoro-femoral bypass in high risk patients

“…Однако сравнительный опыт применения аутовены и синтетических трансплантатов показал их одинаковую эффективность в бедренно-бедренной позиции [8]. Поэтому для бедреннобедренного шунтирования большинство ангиохирургов используют синтетический протез, оставляя аутовену для выполнения последующих реконструктивных операций на артериях нижних конечностей [1,2,[4][5][6][7][8]. Проведенные ранее экспериментальные исследования имплантации синтетического и биологического протезов на артериальную стенку показали, что биологический протез обладает большей биосовместимостью, чем синтетический [9].…”