[Thirty years of axillofemoral bypass]

Improvement in axillary-femoral bypass (AFB) surgery thirty years after its first use results mainly from progress in prosthetic material, particularly external reinforcement cuffs. Indications for use remain those of aorto-iliac surgery in patients at high general or local risk. However, since the primary permeability rate was fairly poor prior to the appearance of non reinforced prostheses, the use of AFB was replaced by other techniques, notably endoluminal procedures. At the same time, contraindications to aorto-iliac surgery were reduced because of the improved global care of these patients and the possibility of treatment in situ of aortic infections. However, the excellent results of the most recent series using only strengthened prosthesis have stimulated renewed interest in AFB, which should always be evoked as a possibility in patients at risk for aorto-iliac surgery.