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Femorofemoral bypass: a profile of graft failure
M A Farber1, L H Hollier, R Eubanks
1Department of Surgery, Ochsner Clinic, New Orleans, La. 70121.
Insights
Femorofemoral bypass surgery for unilateral iliac artery issues offers good long-term patency. Inadequate run-off and outflow disease progression were identified as key factors for graft failure.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Surgical Outcomes Research
Background:
- Unilateral iliac artery occlusion or stenosis significantly impacts lower limb perfusion.
- Femorofemoral bypass is a surgical option to restore blood flow.
Purpose of the Study:
- To evaluate the outcomes of femorofemoral bypass for unilateral iliac artery disease.
- To identify factors contributing to graft failure.
Main Methods:
- Retrospective review of 71 patients undergoing femorofemoral bypass.
- Analysis of morbidity, mortality, symptom relief, and graft patency (early and long-term).
Main Results:
- Overall hospital mortality was 4%.
- One-year and 2-year survival rates were 84% and 81%, respectively.
- Graft patency was 98.5% at 1 month, 91% at 1 year, and 82% at 5 years.
Conclusions:
- Femorofemoral bypass provides durable patency for unilateral iliac artery disease.
- Graft failure is primarily associated with inadequate run-off and progression of outflow disease.
Abstract:
We have reviewed our experience with 71 patients who had a femorofemoral bypass for unilateral iliac artery occlusion or stenosis. We analyzed morbidity, mortality, initial relief of symptoms, early patency, and long-term primary and secondary patency; and we attempted to identify the cause of graft failure. The overall hospital mortality after operative repair was 4%. One-year survival was 84% and 2-year survival was 81%. Early patency was 98.5% at 1 month, late patency was 91% at 1 year and 82% at 5 years. The major cause of graft failure was inadequate run-off and outflow disease progression.