Femorofemoral bypass: a valuable procedure

Twenty-seven femorofemoral bypasses were performed in 25 patients with severe arteriosclerosis obliterans affecting the iliofemoral arteries. The series comprised 16 men and 9 women, aged 51 to 80 years. Nineteen patients were poor-risk cases with severe cardiorespiratory disease. Twenty-one patients had undergone vascular procedures previously without success. The operation was carried out: (a) as the primary procedure for very poor-risk patients in an attempt to salvage a limb, (b) to deal with unilateral limb occlusion of an aortoiliac--femoral prosthesis, or (c) as management of infected prosthetic grafts. Fourteen Dacron grafts and 13 saphenous veins were used for the bypasses. There were no operative deaths. Twenty-two patients were clinically improved, two required amputation later and one patient was lost to follow-up. Four patients, including three with preexisting graft infection, had wound infections that cleared with drainage and antibiotics. No other major complications occurred in this group of poor-risk patients. Femorofemoral bypass is safe and provides the surgeon with a useful method of revascularizing the limbs of selected patients.