Axillo-femoral Bypass for Arteriosclerotic Occlusive Disease / 日本心臓血管外科学会雑誌

ABSTRACT

During a twelve-year period (1982-1993), 15 axillo-femoral bypass surgeries have been performed for aortoiliac occlusive disease. All patients were men, with an average age of 71.2 years. Axillo-bifemoral bypass was performed in 10 cases, and axillo-unifemoral bypass in 5 cases. In Additional femoro-popliteal bypass was required 3 cases. All cases had some accompanying disease, so they were considered to be high risk cases for anatomic bypass surgery. In the 12 elective cases, 2 hospital deaths (16.7%) occured due to the accompaning disease (atrial fibrillation and lung canser). At discharged leg symptoms had improved in 10 patients. In the long term postoperative phase, 4 patients died due to accompanying disease, and one was lost to follow up. Excluding these patients, the long term patency in the 5 surviving patients was 100%. In this series, we encountered a case of perigraft seroma, which is rare. The intractable perigraft seroma disappeared after the reoperation with another material graft. Axillo-femoral bypass is preferable for high risk patients with aortoiliac occlusive disease. In cases of severe respiratory dysfunction, it can be performed under epidural and local anesthesia.