Bilateral aorto-femoral bypass in the presence of aorto-iliac occlusive disease and factors determining results. Experience and long term follow up with 500 consecutive cases.

Abstract Late results and respective determinant factors on the basis of 500 consecutive aortic bi-femoral bypass, are presented. Critical analysis of the outcome, in terms of graft patency, limb salvage and death rate, is based upon comparative studies by means of life table evaluation covering a follow up of slightly over 14 years. A favorable outcome was definitely related to the extent of peripheral arterial involvement and associated pathology, mainly coronary artery disease and hypertension. Operative mortality was 3.2%. Immediate graft patency was obtained in a rate of 98.8%, while late patency in 5 and 10 years was found to be 87% and 78% respectively. Amputation rate was 5.6%. Associated carotid and renal artery stenosis, uni and/or bilateral, were corrected surgically in a preliminary operative procedure in the former (9%) and concomitantly in the latter case (5%). Comparative late results according to associated pathology and distal arterial disease, together with complication rate and late mortality, are given in detail in the text by means of statistical data and illustrative curves.