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Article
December 1982

Evaluation of End-to-Side v End-to-End Proximal Anastomosis in Aortobifemoral Bypass

Author Affiliations

From the Departments of Surgery, University of Kansas College of Health Sciences, Kansas City, Ks (Drs Pierce, Hardin, Hemreck, and Thomas, Mr Turrentine, and Mr Stringfield) and Kansas City (Mo) Veterans Administration Medical Center (Drs Pierce, Iliopoulos, and Thomas).

Arch Surg. 1982;117(12):1580-1588. doi:10.1001/archsurg.1982.01380360056009
Abstract

• The cumulative graft-limb patency rate was significantly higher after aortobifemoral bypass with a proximal end-to-end anastomosis (E-E-AN) than with a proximal end-to-side anastomosis (E-S-AN), 100% v 93%, respectively, after 1.5 years in a consecutive series of 38 E-S-ANs followed by 41 E-E-ANs. The two operations were equally effective in relieving hip claudication, but impotence occurred more frequently after E-E-AN (27%) than after E-S-AN (13%). This difference was not significant, but six of ten patients with E-E-AN who became impotent had arteriographic patterns predicting that graft flow into hypogastric arteries might be compromised. Intraoperative studies demonstrated that acute bilateral occlusion of hypogastric arteries significantly decreases penile BP, but branches of the external iliac arteries also contribute to penile flow and may become the major route of supply in patients with hypogastric occlusive disease.

(Arch Surg 1982;117:1580-1588)

References
1.
Gomes MR, Bernatz PE, Juergens JL:  Aortoiliac surgery: Influence of clinical factors on results . Arch Surg 1967;95:387-394.Article
2.
Duncan WC, Linton RR, Darling RC:  Aortoiliofemoral atherosclerotic occlusive disease: Comparative results of endarterectomy and Dacron bypass grafts . Surgery 1971;70:974-984.
3.
Gaylis H:  Aorto-iliac by-pass grafting: End-to-end or end-to-side anastomosis . S Afr J Surg 1973;11:45-49.
4.
Dean RH, Foster JH:  Aortoiliac occlusive disease: Fifteen years' operative experience . South Med J 1973;66:813-817.Article
5.
Mulcare RJ, Royster TS, Lynn RA, et al:  Long-term results of operative therapy for aortoiliac disease . Arch Surg 1978;113:601-604.Article
6.
Brewster DC, Darling RC:  Optimal methods of aortoiliac reconstruction . Surgery 1978;84:739-748.
7.
Crawford ES, Bomberger RA, Glaeser DH, et al:  Aortoiliac occlusive disease: Factors influencing survival and function following reconstructive operation over a 25-year period . Surgery 1981;90:1055-1066.
8.
Malone JM, Moore WS, Goldstone J:  The natural history of bilateral aortofemoral bypass grafts for ischemia of the lower extremeties . Arch Surg 1975;110:1300-1306.Article
9.
Satiani B, Liapis CD, Evans WE:  Aortofemoral bypass for severe limb ischemia: Long term survival and limb salvage . Am J Surg 1981;141:252-256.Article
10.
LoGerfo FW, Soncrant T, Teel T, et al:  Boundary layer separation in models of side-to-end arterial anastomoses . Arch Surg 1979;114:1369-1373.Article
11.
Queral LA, Whitehouse WM, Flinn WR, et al:  Pelvic hemodynamics after aortoiliac reconstruction . Surgery 1979;86:799-809.
12.
Flanigan DP, Schaler JJ, Keifer T, et al:  Elimination of iatrogenic impotence and improvement of sexual function after aortoiliac revascularization . Arch Surg 1982;117:544-550.Article
13.
May AG, DeWeese JA, Rob CG:  Changes in sexual fuction following operation on the abdominal aorta . Surgery 1969;65:41-47.
14.
Weinstein MH, Machleder HI:  Sexual function after aorto-iliac surgery . Ann Surg 1975;181:787-790.Article
15.
DePalma RG, Levine SB, Feldman S:  Preservation of erectile function after aortoiliac reconstruction . Arch Surg 1978;113:958-962.Article
16.
Szilagyi DE, Whitcomb JG, Waibel P, et al:  Hemodynamic factors in arterial grafting: An experimental study of anastomotic types, graft size and graft surface characteristics . Surg Forum 1958;9:319-324.
17.
Kempczinski RF:  Role of the vascular diagnostic laboratory in the evaluation of male impotence . Am J Surg 1979;138:278-282.Article
18.
Stokes JM, Sugg WL, Butcher HR Jr:  Standard method of assessing relative effectiveness of therapies for arterial occlusive disease . Ann Surg 1963;157:343-350.Article
19.
Federman DD:  Impotence: Etiology and management . Hosp Pract 1982;17:155-159.
20.
Billet A, Dagher FJ, Queral LA:  Surgical correction of vasculogenic impotence in a patient after bilateral renal transplantation . Surgery 1982; 91:108-111.
21.
Merchant RF Jr, DePalma RG:  Effects of femorofemoral grafts on postoperative sexual function: Correlation with penile pulse volume recordings Surgery 1981;90:962-970.
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