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Axillofemoral bypass. Expectations and results
Archives of Surgery (Chicago, Ill. : 1960)
|September 1, 1986
Summary
Axillofemoral bypass using polytetrafluoroethylene (PTFE) grafts can be a viable option for limb salvage in high-risk patients. While graft patency remains high, patient survival rates are lower, highlighting the critical nature of these procedures.
Area of Science:
- Vascular Surgery
- Grafting Procedures
- Limb Salvage Interventions
Background:
- Peripheral artery disease often necessitates complex surgical interventions.
- Limb salvage is a critical goal in managing severe peripheral artery disease.
- Axillofemoral bypass is an alternative revascularization strategy for specific patient populations.
Purpose of the Study:
- To evaluate the outcomes of axillofemoral bypass using polytetrafluoroethylene (PTFE) grafts.
- To assess graft patency and patient survival in patients undergoing this procedure for limb salvage.
- To compare the efficacy of axillofemoral bypass with other revascularization techniques in high-risk individuals.
Main Methods:
- Retrospective study of 33 patients receiving axillofemoral or axillofemorofemoral PTFE grafts.
- Follow-up period ranged from 6 to 60 months.
- Analysis of operative mortality, amputation rates, graft patency, and patient survival.
Main Results:
- 30-day operative mortality was 7% (elective/urgent) and 67% (emergency).
- Cumulative graft patency was 91% at 3 years and 75% at 5 years.
- Patient survival was 54% at 3 years and 41% at 5 years, with graft patency exceeding survival.
Conclusions:
- Axillofemoral bypass with PTFE grafts provides acceptable long-term patency for limb salvage in select high-risk patients.
- Graft patency rates surpass patient survival rates, underscoring the severity of underlying conditions.
- This procedure serves as a valuable alternative to in situ aortofemoral grafts for specific indications.