THE SIGNIFICANCE OF DONOR LEG DISTAL RUNOFF IN FEMOROFEMORAL BYPASS-GRAFTING

Background: The aim of this study is to determine if femorofemoral byp ass grafting is an effective operation for unilateral iliac occlusive disease, and to assess for factors that may predict a poorer outcome. A retrospective review was conducted of cases identified from a prospe ctive audit database. Methods: Information was obtained from the clini cal notes of 97 patients who had 100 femorofemoral bypass graft operat ions. All living patients were invited for assessment which included c olour duplex sonography of the graft and measurement of the ankle brac hial index. Results: Using Life-table analysis, the five-year graft se condary patency for claudicants was 79% and for those with critical is chaemia 78%. Five-year survival for claudicants was 65% and for those with critical ischaemia, 38%. Poor distal runoff in the infrapopliteal arteries of the donor limb adversely affected graft patency. Graft su rvival was not affected by the indication for operation, by donor or r ecipient superficial femoral artery patency, or by the need for endart erectomy, pre-operative angioplasty or the graft material. Conclusions : Femorofemoral bypass grafting is the procedure of choice for all pat ients who require surgical intervention for unilateral iliac occlusion and donor limb distal runoff may be an important determinant of graft patency.