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Iliofemoral versus femorofemoral bypass: a 6-year audit
R L Ng1, T E Gillies, A H Davies
1Vascular Studies Department, Bristol Royal Infirmary, UK.
Insights
Femorofemoral bypass surgery offers superior long-term patency and survival rates compared to iliofemoral bypass. This vascular reconstruction technique also results in shorter hospital stays for patients.
Area of Science:
- Vascular Surgery
- Surgical Outcomes
- Graft Patency
Background:
- Iliac artery occlusive disease often requires surgical intervention.
- Both iliofemoral and femorofemoral bypass are established revascularization techniques.
- Comparative outcome data is essential for surgical decision-making.
Purpose of the Study:
- To compare the outcomes of iliofemoral bypass versus femorofemoral crossover bypass.
- To evaluate early mortality, reoperation rates, graft patency, and survival.
- To assess the impact on hospital stay.
Main Methods:
- Retrospective review of 231 iliofemoral and femorofemoral bypass operations.
- Data collected from 1984 to 1990.
- Analysis of early mortality, reoperation, cumulative patency, survival, and hospital stay.
Main Results:
- Femorofemoral bypass had lower early mortality (1.3% vs 6%) and reoperation rates (16% vs 31%).
- Cumulative patency at 6 years was significantly higher for femorofemoral (92%) versus iliofemoral (75%) bypass (P < 0.01).
- Survival rates at 6 years were also higher for femorofemoral (74%) versus iliofemoral (55%) bypass (P < 0.01), with shorter hospital stays.
Conclusions:
- Femorofemoral crossover bypass demonstrates superior long-term results compared to iliofemoral bypass.
- The femorofemoral technique is associated with improved graft patency, survival, and reduced morbidity.
- Shorter hospital stay further supports the femorofemoral approach in selected patients.
Abstract:
Iliofemoral and femorofemoral crossover bypass operations performed over a 6-year period were reviewed. A total of 226 patients underwent 231 operations from 1984 to 1990. Seventy-two patients had 75 iliofemoral grafts and 154 patients had 156 femorofemoral grafts. The early mortality rate was 6 per cent for the iliofemoral group and 1.3 per cent for femorofemoral reconstruction. There was a higher reoperation rate in the iliofemoral group (31 versus 16.0 per cent). The cumulative patency rate at 6 years was 75 per cent for iliofemoral bypass and 92 per cent for the femorofemoral procedure (P < 0.01), while the survival rates for the same period were 55 and 74 per cent respectively (P < 0.01). Hospital stay was significantly shorter for patients undergoing femorofemoral bypass (P < 0.05).