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Published on: August 1, 2025
Long-term graft occlusion in aortobifemoral position
Novak Vasić1, Lazar Davidović, Dragan Marković
1Clinic for Special Surgical Skills, Clinical Center Banja Luka, Banja Luka, Bosnia and Herzegovina.
Vojnosanitetski Pregled
|September 28, 2013
Summary
Long-term aortobifemoral bypass occlusion is often caused by issues at the distal anastomosis. Thrombectomy with distal anastomosis patch plasty has the highest failure rate, while other methods show better graft patency.
Area of Science:
- Vascular Surgery
- Surgical Complications
- Graft Patency
Background:
- Aortobifemoral (AFF) bypass is a primary treatment for aortoiliac occlusive disease.
- Long-term graft occlusion is a significant complication of AFF bypass procedures.
Purpose of the Study:
- To identify the causes of long-term aortobifemoral bypass occlusion.
- To evaluate the effectiveness of early treatment strategies for graft occlusion.
Main Methods:
- Retrospective study of 100 patients with long-term bifurcated Dacron graft occlusion.
- Analysis of graft occlusion causes and treatment outcomes.
- Comparison of different surgical revision techniques.
Main Results:
- Distal anastomosis issues were the most frequent cause of long-term occlusion (p = 0.0001).
- End-to-end proximal anastomosis was linked to higher occlusion rates (p = 0.0278).
- Thrombectomy with distal anastomosis patch plasty had the highest failure rate (p = 0.0028), with 87% primary early patency.
Conclusions:
- Optimal AFF bypass patency can be achieved with proximal end-to-end juxtarenal aortic anastomosis.
- Distal anastomosis on the common femoral or deep femoral artery bifurcation is recommended.
- Successful limb salvage rates of 90% were observed after secondary procedures.
