Axillo-Femoral Bypass

Abstract

Axillo-femoral artery bypass has been an alternative extra-anatomic bypass procedure for aorto-iliac occlusive disease since its introduction in 1963. This extra-anatomic bypass has been used in special conditions where the conven tional aorto-femoral bypass is not possible because of intra-abdominal sepsis or extremely high operative risk for aortic procedure. In order to have reasonable long-term patency report, retrospective review is done on a patient undergoing axillo-femoral artery bypass grafting performed between 1976 to 1981. Twenty- eight axillo-unifemoral bypasses and 43 axillo-bifemoral bypasses were per formed in this period. Fifty percent of the patient population had multiple risk factors. Arteriosclerotic heart disease was found in 41 %, central nervous system problem and stroke were found in 31%. Twenty-five percent of the patients were diabetic. Five-year patency rate of axillo-bifemoral bypass graft was 75%. Axillo-unifemoral bypass had a five-year patency of 33%. Axillo-unifemoral bypass with femoral-distal bypass had a five-year patency rate of 6 to 8%. Ax illo-bilateral femoral bypass with femoral-distal bypass had 56.2% of a five- year patency. Overall, five-year patency, without thrombectomy was 60%.