New concepts in the use of axillofemoral bypass grafts
R. E. Ward, J. W. Holcroft, S. Conti and F. W. Blaisdell
Over a four-year period, 52 patients underwent axillofemoral bypass
operations. Indications for operation were divided into three groups: those
that were performed emergently (aortoenteric fistula, graft infection, and
leaking aortic aneurysm), those performed electively for aneurysm, and
those for ischemia. Operative procedures were categorized as follows:
axillofemoral bypass alone, axillofemorofemoral bypass with the proximal
femorofemoral anastomosis being graft to graft, or axillofemorofemoral
bypass with the femorofemoral anastomosis to either a transected proximal
common femoral artery or superficial femoral artery distal to the
axillofemoral anastomosis. Thirty-three percent of the unilateral
axillofemoral grafts failed, while only 14% of the axillobifemoral grafts
failed. There was a further difference between the two methods of
femorofemoral grafting with 22% failure in the former group but no failures
in the latter.
