Axillofemoral bypass operations in Kuopio University Hospital 1985-1996.

Background and aims: Axillofemoral bypass has been used since the 1960's in poor-risk patients with aortoiliac atherosclerotic occlusive disease to improve arterial circulation in the lower extremities. This article describes the outcome of 84 consecutive operations in our hospital.

Material and methods: During the period 1.1.1985-31.5.1996, 84 axillofemoral bypass operations were performed in our hospital. In this retrospective study, information was based on patient records and clinical follow-up examination for surviving patients living in the area of Kuopio province and operated before the end of 1995. Patencies and survivals were established using the life table method.

Results: The primary patency rate was 81.1 % at one year, 64.3 % at three years and 56.7 % at five years. The secondary patency rates were 92.1%, 67.1% and 57.7 %, respectively. The operative mortality rate was 6.0%. Eighty-five percent of the patients were alive one year after the operation, compared to 50 % after five years. Serious complications were rare, but local wound complications occurred in 29 %. Vascular reoperations were needed in 29 %, particularly thrombectomies.

Conclusions: Axillofemoral bypass gives acceptable results in the treatment of lower leg ischaemia in elderly poor-risk patients.