A comparison of the early noninvasive hemodynamic results after aortofemoral or axillofemoral bypass graft.

Aortofemoral (AF) and axillofemoral bypass grafts (AXFG) are alleged to have similar patency rates, but little is known of their comparative functional results. In 91 limbs clinically selected for AXFG or AF, pulse volume recording amplitude (PVR) and Dopper systolic ankle/brachial artery pressure ratio (DSP A/B) were measured before and 6 months after surgery. Preoperatively, the limbs were classified by angiography into aortoiliac disease alone (AI) or AI and femoropopliteal disease (AIFP), and were further classified by PVR and DSP A/B into claudication and limb salvage groups. Six months after surgery, the degree of hemodynamic improvement was comparable for AF and AXFG for limbs with AI. After AXFG in AIFP, however, the claudication group showed less of an improvement in DSP A/B ratio and PVR than with AF. There was no functional improvement after AXFG in the limb salvage group. AF appears to be associated with better functional results than AXFG in AIFP.