Crossover femorofemoral grafts followed up five years or more. An analysis.

Crossover femorofemoral grafts continue to provide satisfactory long-term patency with low morbidity and mortality in the treatment of unilateral atherosclerotic iliac artery occlusion. In our series of patients, early failures were primarily a result of the inability to provide adequate runoff for the graft, and late failures were due to progressive atherosclerotic involvement of runoff vessels. Clear-cut progression of the atherosclerotic process in the donor iliac artery segment has not been observed in this series. In fact, there is evidence that suggests that this process may have been retarded when compared with other types of reconstructive procedures. There is a noticeably late mortality (33%) due to other disease processes and associated cardiovascular disorders. These facts continue to support the application of crossover femorofemoral grafts in the surgical treatment of unilateral atherosclerotic illiac artery occlusions.