EVALUATION OF EFFECTIVENESS OF FEMORO-FEMORAL BYPASS SURGERY

Abstract

Thirty-two cases with iliac artery lesions were treated with femoro-femoral bypass (FF bypass) surgery. The mean degree of symptomatology, on Fontaine's classification, was 2.39 prior to surgery. In ten cases, preoperative evaluation showed the iliac artery lesion on the donor side. Iliaco-femoral bypass was done in one case, iliaco-femoro-popliteal sequential bypass in two and thromboendoarterectomy in one. In five cases, donor side lesions were mild and left untreated. To improve run-off on the recipient side, profundaplasty was performed in six cases, lumbar sympathectomy in two, and Fogarty catheter thrombectomy for acute obstruction in two. In one case, aortocoronary bypass was performed concurrently for concomitant coronary lesions. In our series, the 3-year cumulative patency rate of the grafts was 96.3%. In one case, poor peripheral run-off resulted in the only case of early phase obstruction. We conclude that femoro-femoral bypass is effective and good long-term patency will result, as long as peripheral run-off is maintained at the recipient side. However, widening of the indication to the young is not recommended due to the steal phenomenon.