[Indications for aorto and iliofemoral bridges]

As distinct from aneurysmal and embolic lesions, chronic aorto-iliac obliterating lesions often involve a difficult choice of therapy: whether to be optimistic and treat the lesions medically because they are discrete and not dangerous; to amputate because the lesions are too advanced; to carry out careful consservative surgery, hyperaemizing surgery, or alternatively more radical surgery involving deobliteration or bridging. The clinical picture (general condition, social context, clinical stage, unilateral or bilateral lesions) will influence the decision, but the last word depends on the aorto-arteriographic picture and on the result of vasomotor tests. Arterial reconstruction by bridging using a Dacron prosthesis is not advised except in a minority of cases.