Extended axillopopliteal-axillotibial bypass. Valuable adjunct to limb revascularization
J. H. Kwaan and J. E. Connolly
Although axillofemoral bypass is now widely used, little has been reported
of its more distal extension. Our experience in 12 patients with
axillopopliteal (nine) and axillopopliteal-tibial (APT) (three) bypass form
the basis of this report. Indications for these extended bypasses included
suppurative groin infections and obliterated common and profunda femoris
arteries. These procedures were rapidly performed in poor-risk and often
critically ill patients. One patient died of recurrent aortoduodenal
hemorrhage three weeks following successful APT bypass. The other 11
patients enjoyed patent grafts for periods ranging from six months to two
years, although four of these patients successfully underwent a declotting
procedure during this period. The early results of these extended APT
grafts have been gratifying. This technique would seem to be especially
promising for the management of limb ischemia or for rerouting in patients
with infected aortic prosthesis.
