DOES DONOR ILIAC ARTERY PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY OR STENT PLACEMENT INFLUENCE THE RESULTS OF FEMOROFEMORAL BYPASS - ANALYSIS OF 70 CONSECUTIVE CASES WITH LONG-TERM FOLLOW-UP

Purpose: Femorofemoral bypass procedures are being performed with incr easing frequency in some patients with bilateral disease in whom the ' 'donor'' iliac artery undergoes percutaneous transluminal angioplasty or stent placement. This study was undertaken to critically examine th e efficacy of this approach. Methods: The records of 70 consecutive pa tients who over a 14-year period underwent elective femorofemoral bypa ss procedures for chronic occlusive disease, including those who did ( group I; n = 26) and did not (group II; n = 44) undergo donor iliac pe rcutaneous transluminal angioplasty or stent placement, were reviewed. Results: No significant differences were found between group I and II patients with respect: to age, gender, risk factors, surgical indicat ions, preoperative ankle-arm indices, and the performance of associate d procedures. One patient (1.4%) died of a myocardial infarction; no o ther major cardiopulmonary complications occurred. The postoperative c hange in the group I donor limb ankle-brachial index ranged from -0.18 to 0.11 (mean, 0.00), revealing no significant steal. The primary gra ft patency rates for group I and II patients 30 days after surgery wer e 92% and 98%, respectively, and at 1, 3, 5, and 7 years after surgery were 87% and 81%, 79% and 73%, 79% and 59%, and 66% and 59%. Conclusi ons: Donor iliac artery percutaneous transluminal angioplasty or stent placement does not compromise the results of femorofemoral bypass pro cedures in patients with chronic iliac artery occlusive disease.