Usefulness and applicability of femorofemoral crossover bypass grafting

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine

Background:

• Femorofemoral crossover bypass grafting (FFC) is a surgical technique used to treat peripheral artery disease.
• Assessing the long-term efficacy and influencing factors of FFC is crucial for patient management.

Purpose of the Study:

• To evaluate the clinical usefulness and patency rates of femorofemoral crossover bypass grafting (FFC).
• To identify factors influencing the outcomes of FFC procedures.

Main Methods:

• Retrospective analysis of 95 FFC procedures performed over a 5-year period.
• Kaplan-Meier analysis for patency rates (follow-up 40.4 ± 3.0 months).
• Clinical outcome assessment using Rutherford's standardized categories; analysis of cardiovascular risk factors and technical characteristics.

Main Results:

• 89% of patients showed improved limb clinical status post-FFC.
• One- and 5-year primary patency rates were 88.2% and 57.3%; primary assisted 90.6% and 62.4%; secondary 92.6% and 68.1%.
• Better clinical outcomes were observed in patients with preoperative femoral artery stenosis <50% (p=0.033); no predictors for patency were identified.

Conclusions:

• FFC is effective long-term across all age groups, irrespective of cardiovascular risk factors.
• Preoperative degree of stenosis (<50%) is the strongest predictor of favorable clinical outcome.
• Success evaluation requires combining graft patency with clinical outcomes.