Extra-anatomic bypass grafting in the lower extremity.

Between January 1975 and December 1980, 104 extra-anatomic bypasses were performed on 102 patients. Of these, there were 81 femorofemoral bypasses on 80 patients and 23 axillofemoral bypasses on 22 patients. Those who underwent femorofemoral grafting were divided into three groups: group 1 - 18 patients who had undergone previous aortofemoral bypass grafting with occlusion of one limb of the graft, group 2 - 17 patients who were considered to be at high risk and group 3 - 45 patients who could have tolerated a conventional reconstructive procedure. Our results indicate that the cumulative patency rate of the femorofemoral bypass at the end of 1 year and 5 years is good and that this operation is an excellent first choice procedure in cases of unilateral iliac disease, to relieve severe ischemia or disabling claudication, whether the patient is a poor or good operative risk. On the other hand, axillofemoral grafting has a lower patency rate and should be reserved for high-risk patients and for the relief of severe ischemia only.