Aorto-femoral bypass: A multicenter retrospective study of 281 cases

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.