Axillofemoral bypass: a ten-year review.

Area of Science:

• Vascular Surgery
• Biomaterials Science

Background:

• Axillofemoral bypass is a critical surgical technique for treating aortoiliac occlusive disease.
• Graft material and adjunctive procedures significantly influence long-term outcomes.

Purpose of the Study:

• To evaluate the long-term patency rates of axillofemoral and axillobifemoral grafts.
• To compare the efficacy of Dacron versus PTFE grafts.
• To assess the impact of thrombectomy on graft patency.

Main Methods:

• Retrospective analysis of 106 axillofemoral and axillobifemoral grafts implanted between 1969 and 1980.
• Life table analysis to determine cumulative patency rates.
• Comparison of graft patency with and without thrombectomy.

Main Results:

• Dacron axillofemoral grafts demonstrated high cumulative patency (97% at 32 months).
• Thrombectomy significantly improved patency rates for both unilateral and bifemoral grafts.
• No significant difference in patency was observed between Dacron and PTFE grafts.

Conclusions:

• Axillofemoral grafting provides durable patency and is a valuable alternative to aortoiliac reconstruction.
• Thrombectomy is a beneficial adjunct for enhancing graft longevity.
• This technique is particularly suitable for elderly patients with high-risk comorbidities.