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James J. Schuler, MD; D. Preston Flanigan, MD; Timothy J. Ryan, MD; Dale Buchbinder, MD; John J. Castronuovo, MD

Arch Surg. 1984;119(4):456-461.

Abstract
• We evaluated the effectiveness of crossover femorofemoropopliteal sequential bypass in 13 patients with combined ipsilateral iliac and femoropopliteal disease. Of them, eight underwent bypass grafting for limb salvage, and five, for disabling claudication. Four of the patients with claudication had relief of symptoms and significant increases in treadmill walking time. The cumulative limb salvage rate in the patients operated on for limb salvage was 88%. At 42 months, the cumulative patency rate for the femorofemoral portion of the graft was 91%, and for the distal segment, 63%. Mean ankle-brachial indices increased from 0.37±0.12 preoperatively to 0.76±0.16 postoperatively in the recipient limb. Early experience suggests that crossover sequential femorofemoropopliteal bypass grafts are effective in achieving limb salvage and relief of claudication, especially in patients with relative contraindications to major intra-abdominal surgery.

(Arch Surg 1984;119:456-461)

Author Affiliations
From the Division of Vascular Surgery, Department of Surgery, West Side Veterans Administration Medical Center, Chicago (Dr Buchbinder), and the College of Medicine, University of Illinois at Chicago (Drs Schuler, Flanigan, Ryan, and Castronuovo).

Footnotes
Accepted for publication Dec 15, 1983.

Read before the Seventh Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Airlie, Va, May 28, 1983.

Reprint requests to Division of Vascular Surgery, Department of Surgery, 518-J, University of Illinois at Chicago, PO Box 6998, Chicago, IL 60680 (Dr Flanigan).

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