Axillofemoral bypass. Expectations and results
R. A. Savrin, G. T. Record and D. E. McDowell
We studied 33 patients who received axillofemorofemoral or axillofemoral
polytef (polytetrafluoroethylene [PTFE]) grafts. The follow-up period
ranged from six to 60 months. Most patients were operated on for limb
salvage. The 30-day operative mortality was 7% for elective or urgent
procedures and 67% for emergency procedures. Twelve amputations were
performed, but nine were necessitated by preexisting tissue loss and three
were performed below rather than above the knee following proximal
revascularization. Cumulative graft patency was 91% at three years and 75%
at five years. Patient survival was only 54% at three years and 41% at five
years. Graft patency exceeded patient survival at every interval. In a
select group of high-risk patients requiring proximal revascularization for
limb salvage, axillofemorofemoral bypass offers an acceptable alternative
to an in situ aortofemoral graft.
