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Femorofemoral crossover grafts for claudication: a safe and reliable procedure
M Berce1, R D Sayers, J H Miller
1Department of Vascular Surgery, Royal Adelaide Hospital, South Australia.
Objective:
To evaluate the role of femorofemoral crossover grafts in patients with disabling claudication.
Design:
Retrospective study.
Setting:
University hospital.
Materials:
Two hundred and eleven patients with iliac artery disease undergoing femorofemoral crossover grafts for disabling claudication.
Chief Outcome Measures:
Perioperative mortality, follow-up cumulative graft patency, limb loss, survival, graft infection and false aneurysm formation were evaluated to determine the immediate and long-term outcome of the procedure.
Main Results:
Primary and secondary graft patency at 5 years was 72% and 89% respectively. There were no perioperative deaths (zero 30 day mortality). Dacron was used in 66 patients (31%) and PTFE in 145 (69%). There were no differences in patency between the two graft materials but eight Dacron grafts (12.1%) were removed because of complications (false aneurysm or infection) compared to four PTFE grafts (2.7%) (p < 0.001 Chi-square). Five patients (2%) have undergone a major lower limb amputation. Forty-one patients (19%) have required subsequent inflow procedures which represents a cumulative need for inflow of 5% per year.
Conclusions:
Femorofemoral crossover grafts are a safe and reliable procedure in patients with disabling claudication caused by unilateral iliac artery disease.