The iliac-origin arterial graft: a useful alternative for iliac occlusive disease.

The results of ilioiliac and iliofemoral bypass grafts were compared with those for aortic-origin grafts in 205 patients and 332 legs operated upon for aortoiliac occlusive disease since 1972. Poor-risk patients who had a patent distal aorta and at least one functionally patent proximal iliac artery were considered for reconstruction with the iliac artery used for the proximal anastomosis. The procedure, performed through a retroperitoneal approach, has several technical advantages and is especially satisfactory for patients who would otherwise have an axillofemoral graft. The data indicate that these iliac-origin reconstructions compare favorably in patency with aortic-origin reconstructions or with other "extra-anatomic" arterial reconstructions, enabling extremely low morbidity and mortality rates even in high-risk patients.