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The femoro-femoral cross-over bypass
L N van Adrichem1, D P van Berge Henegouwen, H J Lobach
1Department of Surgery, St. Elisabeth Ziekenhuis, Tilburg, The Netherlands.
The Netherlands Journal of Surgery
|June 1, 1991
Summary
Femoro-femoral cross-over bypass is effective for unilateral iliac artery occlusion. This procedure offers good patency and limb-salvage rates, especially in primary cases for critical ischemia.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Surgical Outcomes
Background:
- Unilateral iliac artery occlusion presents treatment challenges.
- Central reconstruction may be unsuitable for certain patient groups (e.g., elderly, comorbidities).
- Previous aortobifemoral bypass failure necessitates alternative revascularization strategies.
Purpose of the Study:
- To evaluate the efficacy and outcomes of femoro-femoral cross-over bypass.
- To assess patency rates and limb salvage in patients with unilateral iliac artery occlusion.
- To determine the suitability of cross-over bypass as a primary treatment option.
Main Methods:
- Retrospective analysis of 64 patients undergoing femoro-femoral cross-over bypass (1984-1990).
- 45 primary and 19 secondary procedures were performed.
- Patient selection considered factors precluding central reconstruction and previous bypass failures.
Main Results:
- Overall three-year patency rate was 78%.
- Primary cross-over bypasses demonstrated high patency (80% primary, 85% secondary).
- Favorable limb salvage (91%) was achieved in 23 primary cases for critical ischemia (Fontaine stage III/IV).
- Mortality rate was 5% (3 patients).
Conclusions:
- Femoro-femoral cross-over bypass is a recommended first-choice therapy for unilateral iliac artery occlusion.
- The procedure shows excellent outcomes, particularly for primary interventions in critical limb ischemia.
- It provides a viable alternative when central reconstruction is contraindicated or previous bypasses have failed.