Femoro-femoral cross-over grafting. A limb-saving operation in poor-risk patients with obliterative arteriosclerosis.

A series of 12 femoro-femoral cross-over grafting procedures is reported. Eleven patients were operated on for severe ischaemia and one for disabling claudication. Nine of the reconstructions were profunda revascularizations. Concomitant femorotibial reconstruction was carried out in one case. There were no operative deaths or postoperative complications. Peroperative blood flow measurements and clinical symptoms gave no evidence of any "steal" phenomenon. One graft became occluded primarily, but the others remained patent during an observation period ranging from two months to four years and ten months. Despite a functioning graft, one major amputation was necessary due to severe distal arteriosclerotic lesions. In all other patients, either the limb was saved or claudication was relieved. This operation seems to be suitable for poor-risk patients with predominantly unilateral iliac arteriosclerosis together with impending gangrene or disabling claudication.