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Compromise or Preference: A Reappraisal

Donald K. Brief, MD; Joseph Alpert, MD; Victor Parsonnet, MD

AMA Arch Surg. 1972;105(6):889-894.

Abstract
A series of 66 crossover femoro-femoral grafts performed during the past six years is reported. There were four early and three late graft closures at 4, 8, and 30 months postoperatively, caused by inadequate runoff or subsequent progression of arteriosclerosis distal to the bypass. One graft closure at 15 months was a result of unrecognized inflow occlusion. There has been no evidence of any "steal" phenomenon from the donor leg and flow studies suggest that this does not occur.

One operative death (less than 2%) and 14 late deaths were due primarily to cardiovascular disease. The low mortality, minimal morbidity, and long-term patency rate (84.9% at three, four, and five years) make crossover femoro-femoral grafting the procedure of choice in unilateral aorto-iliac occlusive disease.

Author Affiliations
Newark, NJ

From the Department of Surgery, Newark Beth Israel Medical Center, and the College of Medicine and Dentistry, New Jersey Medical School, Newark, NJ.

Footnotes
Accepted for publication July 11, 1972.

Read before the 20th scientific meeting of the International Cardiovascular Society, Carmel, Calif, June 24, 1972.

Reprint requests to Newark Beth Israel Medical Center, 201 Lyons Ave, Newark, NJ 07112 (Dr. Brief).

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