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To determine predictors of long-term patency in extra-anatomic bypass grafting, the authors studied retrospectively the charts of 134 patients who underwent bypass grafting (axillofemoral in 17, axillobifemoral in 32 and femorofemoral in 85). Of the study group, 64% were men; the mean age was 65 +/- 12 years (+/- SEM). The indications for grafting were limb salvage (102), claudication (27) and replacement of septic grafts (5), and for using the extra-anatomic route included high risk (83), sepsis (8) and unilateral disease (34). Operative mortality was 6% and the early graft occlusion rate 7.4%. The late death rate was 44%. At 3 years, the life-table patency rates for the various procedures were axillofemoral 52.5%, axillobifemoral 67.7% and crossfemoral 86.9%. Smoking significantly (p less than 0.05) decreased the patency rate, but diabetes did not. However, amputation was more frequent in diabetics. Indications for operation did not alter patency rates, but did affect operative mortality. The authors conclude that extra-anatomic bypass grafting is highly successful, but not as successful as anatomic bypass. When appropriate, the axillobifemoral graft is preferred to the axillounifemoral graft because of its increased patency. Crossfemoral grafts must be carefully monitored to ensure that no donor limb stenosis occurs and this procedure should not be attempted unless the disease is truly unilateral.
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
July 1983,
Canadian journal of surgery. Journal canadien de chirurgie,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
November 2000,
Journal of vascular surgery,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
January 1980,
VASA. Zeitschrift fur Gefasskrankheiten,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
January 2004,
Journal of cardiac surgery,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
February 1977,
The American surgeon,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
November 1985,
Irish medical journal,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
September 1994,
Minerva chirurgica,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
January 1984,
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
August 1987,
Kokyu to junkan. Respiration & circulation,
K A Harris, and
V Niesobska, and
S E Carroll, and
G De Rose, and
W G Jamieson, and
G E Meads, and
J P Sweeney
July 1993,
Annals of vascular surgery,
