Femorofemoral bypass: appropriate application based on factors affecting outcome

Current surgical options for the treatment of unilateral iliac artery occlusive disease are quite varied and include aortic-based procedures, femorofemoral bypass ileofemoral bypass, and transluminal angioplasty and stenting. Patients with unilateral iliac disease present with a variety of anatomic, physiological and clinical situations. As a result, the surgical options are complementary rather than competitive, and their use needs to be tailored on an individual basis. Femorofemoral bypass, despite its relatively lower patency rate compared with aortic-based inflow procedures, is a useful operation for the treatment of unilateral limb ischemia. It is best suited for patients with limited life-expectancy and/or for those with contraindications for transabdominal or more extensive surgery, or as a remedial procedure for unilateral limb failure of aortofemoral grafts. The purpose of this article is to analyze the results of femorofemoral bypass, and to discuss the factors that may influence its outcome in the treatment of unilateral iliac artery occlusive disease.