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7028396 
Journal Article 
Axillofemoral bypass for aortoiliac occlusive disease 
Martin, D; Katz, SG; , 
2000 
1 
American Journal of Surgery
ISSN: 0002-9610
EISSN: 1879-1883 
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC 
BRIDGEWATER 
100-103 
11044521 
WOS:000089861200005 
BACKGROUND: Although aortoiliac disease remains a common cause of lower extremity ischemia, the efficacy of axillofemoral bypass in this setting remains controversial. This report summarizes our institutional experience with axillofemoral bypass.METHODS: A retrospective review of consecutive axillofemoral bypass grafts was performed at a single institution between 1984 and 1997. Only patients presenting with chronic aortoiliac occlusive disease were included. Patient demographics, risk factors, indications for surgery and outcomes were recorded. Survival curves for primary patency were plotted using the Kaplan-Meier method according to the standards set by the Society of Vascular Surgery-International Society for Cardiovascular Surgery. Comparisons between groups were made using the log rank method. Statistical significance was assumed at P values <0.05.RESULTS: Sixty patients underwent axillofemoral bypass grafting of which 53 were bifemoral and 8 unifemoral, Forty-seven procedures were performed for limb salvage. Primary patency rates at 1, 3, and 5 years were 86%, 72%, and 63%, respectively. Thirty-day mortality rate was 4.9%. Sixty percent of graft occlusions occurred in the femorofemoral limb with continued patency of the axillofemoral limb. Risk factors, type of procedure and superficial femoral artery patency had no statistically significant effect on longterm patency.CONCLUSIONS: In the setting of diffuse, chronic aortoiliac occlusive disease, long-term patency rates of axillofemoral grafts approach those of aortobifemoral bypass and exceed those quoted for percutaneous transluminal angioplasty, with results that are highly reproducible. Axillofemoral bypass is an excellent option in those patients at prohibitive risk for direct aortic reconstruction or those with limited life expectancy. Am J Surg. 2000;180:100-103. (C) 2000 by Excerpta Medica, Inc.