FEMOROFEMORAL CROSSOVER GRAFTS FOR CLAUDICATION - A SAFE AND RELIABLEPROCEDURE

Objective: To evaluate the role of femorofemoral crossover grafts in p atients with disabling claudication. Design: Retrospective study. Sett ing: University hospital. Materials: Two hundred and eleven patients w ith iliac artery disease undergoing femorofemoral crossover grafts for disabling claudication. Chief outcome measures: Perioperative mortali ty, follow-up cumulative graft patency, limb loss, survival, graft inf ection and false aneurysm formation were evaluated to determine the im mediate and long-term outcome of the procedure. Main results: Primary and secondary graft patency at 5 years was 72% and 89% respectively. T here were no perioperative deaths (zero 30 day mortality). Dacron was used in 66 patients (31%) and PTFE in 145 (69%). There were no differe nces in patency between the two graft materials but eight Dacron graft s (12.1%) were removed because of complications (false) aneurysm or in fection) compared to four PTFE grafts (2.7%)(p < 0.001 Chi-square). Fi ve patients (2%) have undergone a major lower limb amputation Forty-on e patients (19%) have required subsequent inflow procedures which repr esents a cumulative need for inflow of 5% per year. Conclusions: Femor ofemoral crossover grafts are a safe and reliable procedure in patient s with disabling claudication caused by unilateral iliac artery diseas e.