Effect of prior arterial reconstruction on the outcome of femorofemoral bypass.

To study the effect of previous arterial reconstruction at the femoral level on the outcome of femorofemoral bypass, 63 male patients who were operated upon from 1977 to 1985 were reviewed retrospectively. Thirty-four patients had no previous surgery (Group A) and 29 had had previous femoral-level surgery (Group B). Both groups were comparable for risk factors and indications for operation. Previous reconstructions included 36 inflow and 24 outflow procedures. Operatively, recipient profundaplasty was required in 79 per cent of Group B versus 32 per cent in Group A. Early results (fewer than 30 days) were comparable for mortality, graft thrombosis, and amputation. Late results showed similar graft thrombosis and cumulative patency rates. The need for reoperation (32 vs 9%) and major amputation (14.8 vs 3%) were increased in Group B but not significantly different. Primary and secondary femorofemoral bypass are both efficacious with the outcome determined by the progression of distal atherosclerosis.