[Axillo-femoral bypass. Long-term results]

Abstract

182 patients underwent axillo-femoral bypass between April 1974 and December 1981 (29 women and 153 men). Mean survival was 43 months. The mean age was 68 years (range: 40-90). 10.9% of patients were Leriche stage II, stages III and IV accounted for 69.7% of cases. All presented a high surgical risk with cardiac disease present in 43.4% and severe respiratory failure in 36.8%. Depending on the year studied, this procedure represented 10 to 15% of the aorto-iliac revascularisations carried out. Mortality was low (5 cases = 2.7%). Early complications (15%) included 11 cases (6%) of early thrombosis requiring reintervention, and late complications included 48 cardiac problems (26.3%). Analysis of the results in the long term was carried out according to an actuarial method over a period of 10 years. The secondary permeability rate was 86.4% at 5 years and 68.8% at 10 years with a 30% secondary thrombectomy rate (25% long term). Limb conservation at 5 and 10 years was respectively 91.1% and 82.7% while for the same periods survival was 46.7% and 19.7%, confirming the grave condition of the patients. We can conclude that axillo-femoral bypass remains a simple and reliable method with good long term results. When extra-anatomical revascularisation seems indicated, it is particularly suitable for subjects in very poor general health.