Summary
Axillofemoral grafts (144 prostheses: 103 unilateral, 25 bifemoral = y-shaped, and
8 bilateral) were performed in a total of 136 patients with aortoiliac occlusion.
The average patient was 69 years old. Surgery was indicated only in “high-risk patients”
in either stage II (n = 7; walking distance until onset of pain less than 50 m), stage
III (n- 55), or stage IV (n = 74). Early occlusion of the prosthesis occurred in 26
cases; 15 were treated successfully by remedial surgery. The total rate of infection
after first and remedial operations was 9.7%. The amputation rate, both early and
late, was 19%. The early results showed that 114 patients had reached stage II (walking
distance until onset of pain over 100 m). The postoperative follow-up period of up
to 116 months (average 27.6 months) revealed that the implanted prostheses had remained
patent in 80% of each group of patients at different postoperative intervals. This
is extraordinary considering their length and course. Four fifths of the patients
lived an average of 22 months, remaining in stage II without loss of limb(s); we believe
it made their life more worth living. We conclude that axillofemoral grafts yield
satisfactory results for a selective group, namely the “high-risk patient” with aortoiliac
occlusion.
Key words
High-risk patient - Aorto-iliac occlusion - Axillofemoral bypass grafts
