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Is Aortoprofunda Bypass a Successful Operation for Multilevel Occlusive Disease?

Division of Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada

K. Wayne Johnston

Division of Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada

Paul M. Walker

Division of Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada

During a ten-year period (1976-1986) at the Toronto General Hospital, 121 patients underwent aortoiliac reconstruction with one or both of the distal anas tomoses to the level of the profunda femoris artery. The cumulative five-year graft patency rate in 117 patients surviving the operation was 97±1.3%, the cumulative five-year clinical success rate (patent graft and clinical improve ment) was 76±5.2%, and the cumulative five-year hemodynamic success rate (patent graft and improved ankle/brachial pressure ratio) was 67±5.9%. There was no significant difference in cumulative clinical success when stratified for sex, preoperative grade (claudication vs limb salvage), proximal anastomosis (end-to-end vs end-to-side), or length of profundoplasty. The authors' experi ence indicates that aortoprofunda bypass is a successful operation for the man agement of multilevel vascular occlusive disease with very few patients requiring subsequent distal revascularization. It is not unusual to observe clini cal improvement despite a relatively small increase in "resting" ankle/brachial index. A gradual decrease in clinical and hemodynamic success can be expected secondary to either anastomotic hyperplasia or progression of distal athero sclerotic disease.

Vascular and Endovascular Surgery, Vol. 23, No. 4, 265-271 (1989)
DOI: 10.1177/153857448902300404


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