Haemodynamics of axillofemoral grafting in a case with normal inflow and outflow vessels

Intra-operative haemodynamics were studied in a case of axillofemoral grafting. When the normal axillary artery acted as the donor artery no steal from the arm occurred, even after vasodilatation in the leg. When, conversely, the very poor arterial collaterals to the leg were required to serve as donor arteries because the axillary artery proximal to the anastomosis was occluded by a clamp, a steal from the leg to the arm was observed. The study supports the concept that only if the donor artery has a high resistance to flow can a steal develop.