The femorofemoral graft. Hemodynamic improvement and patency rate
A. J. Lamerton, A. N. Nicolaides and H. H. Eastcott
We measured the hemodynamic improvement after femorofemoral grafting and
determined the five-year cumulative patency rate in 54 consecutive
high-risk patients with unilateral iliac artery occlusion who had
femorofemoral grafts who were studied with ankle and brachial systolic
pressure measurements before and after operation and at six-month
intervals. There were two early deaths and seven early graft failures (less
than 30 days) with four amputations (all operated on for rest pain). All of
the remaining 45 patients' conditions improved clinically and objectively.
The resting pressure index (mean +/- SD) in claudicants (n = 23) increased
from 0.35 +/- 0.15 to 0.67 +/- 0.20; in patients with severe ischemia (n =
31) it increased from 0.25 +/- 0.15 to 0.50 +/- 0.20. During the follow-up
period (six months to ten years), there were eight deaths and 12 late graft
failures (greater than 30 days). The late cumulative patency rate was 60%
at five years. Hemodynamic improvement parallels clinical success and for
these high-risk patients, the femorofemoral bypass is a satisfactory
alternative to a more major operation.
