Long term results of extra anatomical bypasses

The authors discuss their own experience with extra anatomical bypasses. It is composed by 214 patients who underwent 224 extra anatomical bypasses: 167 axillofemoral bypasses, 50 femorofemoral bypasses and 7 trans-obturator bypasses. The indications included the presence of infections, or a previously thrombosed aortic prosthesis, or infected aneurysm, in 12.1% of the cases; in 6.2% of the cases the extra anatomical bypass was due to acute ischaemia of limb. In 81.7% it was chosen because of the presence of some general or local contraindication to direct aortoiliac reconstruction. The results are comparable to those reported in the literature. The only unusually high datum is the rate of early infections in femorofemoral bypasses (12%). On the ground of these results, the Authors stress the value of extra-anatomical bypasses as an alternative to direct aortoiliac reconstructions.