Abstract
Aorto-femoral (A-F) bypass surgery has been performed commonly and safely as an interventional
therapy for iliac arterial stenosis or obstruction. Recently, catheter intervention
has increasingly replaced this modality. However, no consensus has been reached as
to a lesion-specific treatment choice between bypass surgery and catheter intervention.
We investigated the patency rates after A-F bypasses according to TransAtlantic Inter-Society
Consensus (TASC) classifications. This is a multicenter retrospective analysis of
281 patients on whom A-F bypasses were performed between 1991 and 2000. Follow-up
extended to a maximum of 10.0 years, with a mean of 3.6 years (±2.6 years). The overall
primary patency rate for all grafts was 94.9% at 5 years. The patency rate for the
TASC type-B lesion was lower than that of type-D lesion, with a survival rate at 5
years of 88.0%. The logistic regression analysis revealed that no variables were responsible
for the primary patency rate. Renal failure, and peripheral arterial occlusive disease
were correlated with a decreased survival rate. We conclude that the late results
of A-F bypasses are satisfactory. For the type B lesion, catheter intervention may
have a better indication. Chronic renal failure and peripheral arterial occlusive
disease may decrease the survival rate. The operative indications should be carefully
determined for these cases.
