Extended axillopopliteal-axillotibial bypass. Valuable adjunct to limb revascularization

Although axillofemoral bypass is now widely used, little has been reported of its more distal extension. Our experience in 12 patients with axillopopliteal (nine) and axillopopliteal-tibial (APT) (three) bypass form the basis of this report. Indications for these extended bypasses included suppurative groin infections and obliterated common and profunda femoris arteries. These procedures were rapidly performed in poor-risk and often critically ill patients. One patient died of recurrent aortoduodenal hemorrhage three weeks following successful APT bypass. The other 11 patients enjoyed patent grafts for periods ranging from six months to two years, although four of these patients successfully underwent a declotting procedure during this period. The early results of these extended APT grafts have been gratifying. This technique would seem to be especially promising for the management of limb ischemia or for rerouting in patients with infected aortic prosthesis.