A series of 66 crossover femoro-femoral grafts performed during the past six years is reported. There were four early and three late graft closures at 4, 8, and 30 months postoperatively, caused by inadequate runoff or subsequent progression of arteriosclerosis distal to the bypass. One graft closure at 15 months was a result of unrecognized inflow occlusion. There has been no evidence of any "steal" phenomenon from the donor leg and flow studies suggest that this does not occur.
One operative death (less than 2%) and 14 late deaths were due primarily to cardiovascular disease. The low mortality, minimal morbidity, and long-term patency rate (84.9% at three, four, and five years) make crossover femoro-femoral grafting the procedure of choice in unilateral aorto-iliac occlusive disease.
Brief DK, Alpert J, Parsonnet V. Crossover Femoro-Femoral GraftsCompromise or Preference: A Reappraisal. Arch Surg. 1972;105(6):889-894. doi:10.1001/archsurg.1972.04180120070013