Axillofemoral bypass for limb salvage

Abstract

Objective: To evaluate the early and long-term outcomes of axillofemoral bypass performed at a tertiary referral vascular centre over a 17-year period.

Methods: From 1982 to 1998, 30 patients underwent axillofemoral bypass at the University of Hong Kong Medical Centre. A retrospective analysis of all these records was undertaken. Data on demographic features and results of surgical intervention were reviewed. Early outcomes were analyzed with respect to morbidity, mortality and improvement of clinical category (according to the Reporting Standards of the Society for Vascular Surgery/North American Chapter, International Society for Cardiovascular Surgery). Long-term outcomes were documented with respect to graft patency, patient survival and limb loss rates.

Results: Clinical success was achieved in 22 patients (73%) after operation. The postoperative morbidity and mortality rates were 30% and 20%, respectively. The primary patency of axillofemoral bypass was 62%, 51% and 45% at 1, 2 and 3 years, respectively. Limb loss rate was 23% at 3 years. The cumulative survival rate of the study population was 67%, 57% and 57% at 1, 2 and 3 years, respectively.

Conclusions: Axillofemoral bypass is a valuable limb-salvaging surgical option for revascularization of lower limbs in high-risk patients with aorto-iliac occlusive disease.