Axillofemoral bypass: Compromised bypass for compromised patients***

Abstract Purpose: The procedure of axillofemoral bypass (AXF) grafting has generally been used in the past for patients with serious contraindication to certain reconstructive procedures involving the abdominal aorta. Because some recent series have noted improved results, it has been suggested that the indications for this bypass may be extended. We reviewed our experience with AXF to identify which factors affect outcome, to determine whether recent results have improved, and to determine whether an extension of the use of the procedure is justified by the observed results. Method: One hundred fifty-three AXF, including 80 axillobifemoral bypasses and 73 axillounifemoral bypasses performed between October 1974 and December 1992 were reviewed. Results: Three-year primary and secondary patency rates for the entire group were 49.4% and 65.7%. Primary patency was adversely affected ( p Conclusion: Bifemoral outflow, external support, and more recent surgery were not associated with improved patency rates. Our results do not support extended indications for AXF. (J VASC SURG 1994;20:195-201.)