Eighteen-year experience with femoro-femoral bypass

Background: The role of femoro-femoral bypass in the management of aorto-il iac occlusive disease has evolved during the past two decades. The aim of t he present study was to evaluate the early and long-term outcomes of femoro -femoral bypass grafts performed at the University of Hong Kong Medical Cen tre during an 18-year period. Methods: From 1981 to 1998, a retrospective analysis of 61 patients who und erwent femoro-femoral bypass at the University of Hong Kong Medical Centre was undertaken. Data on demographic features and results of surgical interv ention were reviewed. Early outcomes (morbidity, mortality and improvement of clinical category) and long-term outcomes (graft patency, patient surviv al and limb salvage rates) were analysed. Results: The postoperative morbidity and mortality rates were 16% and 7%, r espectively. Clinical success was achieved in 48 patients (79%) after opera tion. The primary patency of femoro-femoral bypass was 86%, 79% and 71% at 1, 3 and 5 years, respectively. The limb salvage rate was 85% at 3 years. T he cumulative survival rate of the study population was 89%, 82% and 73% at 1, 3 and 5 years, respectively. Conclusions: Femoro-femoral bypass was successful in relieving ischaemic pa in and limb salvage in similar to 80% of patients. A 5-year patency rate of 71% was achieved. Femoro-femoral bypass remains a valuable surgical proced ure for limb salvage in poor-risk patients with unilateral iliac artery occ lusion.