Femoro-femoral graft after unilateral obstruction of aorto-bifemoral bypass.

Background: Thrombosis is the most frequent late complication of surgical procedures in the aortofemoral area. In the presence of aortobifemoral bypass, graft limb occlusion generally occurs within the first two years. Various techniques have been proposed to revascularize the ischemic limb. Personal experience in the treatment of occlusions of aorto-femoral bypasses branch by femoro-femoral bypasses is reported and the immediate and long-term results are analyzed.
Methods: The study was retrospective and the medium follow-up was 51 months (1-14 years). The patients were all operated from 1976 to 1995 in the Division of Vascular Surgery of the University of Bari. The group consisted of 40 patients affected by unilateral occlusion that occurred after aorto-femoral bypass. The femoro-femoral bypass was performed using non-ringed 6 or 8 mm Dacron prostheses; the proximal anastomosis was made a few cm above the femoral anastomosis of the permeable branch of the existing aorto-bifemoral bypass and the distal anastomosis on the cross-leg profunda femoris. Postoperative follow-up consisted of clinical examination, continuous wave Doppler examination or US-color-Doppler scan in order to assess the permeability of the graft.
Results: The immediate results showed 2 and long-term results 9 occlusions of the bypass. No perioperative mortality was observed.
Conclusions: In conclusion the authors consider the use of femoro-femoral bypass indicated in a high number of patients affected by unilateral occlusion of the aorto-bifemoral bypass.