Objective improvement after aortofemoral bypass for exercise ischemia.

The physiologic and functional improvement after aortofemoral bypass was quantitatively assessed by preoperative and postoperative noninvasive vascular testing in two groups of patients operated upon for claudication alone, those with significant occlusive disease of the lower extremity limited to the aortoiliac segments and those with combined disease of both the aortoiliac and superficial femoral arteries. While there is a statistically significant increase in segmental pressures and exercise times after aortofemoral bypass in the group with combined disease, these objective hemodynamic parameters are far from normal and are statistically significantly lower than values obtained in the group of patients with open superficial femoral arteries. Accordingly, we question the advisability of proximal arterial reconstruction in patients with combined hemodynamically significant aortoiliac and occlusive disease of the superficial femoral artery and claudication as the only indication for operation.