Axillofemoral bypass: a ten-year review

During a ten-year period (1969-1980), 106 grafts were implanted in the axillofemoral and axillobifemoral positions. This retrospective study is based on life table analysis of cumulative patency rates in both axillofemoral and axillobifemoral grafts, with and without thrombectomy. Dacron grafts were used exclusively from 1969 to 1979, and PTFE from 1979 to 1980. Cumulative patency for Dacron axillobifemoral grafts was 97 +/- 3% at 32 months (73 +/- 21% at 42 months). Patency in both unilateral and bifemoral grafts was significantly increased by thrombectomy. Dacron and PTFE axillobifemoral graft patency was not significantly different. Perioperative mortality was 8% in a group of patients whose survival rate at four years was only 50 +/- 10% from associated disease. Axillobifemoral grafting presents an alternative to aortoiliac reconstruction in elderly patients with severe associated disease in whom the risk of anatomic bypass is prohibitive.