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December 1972

Aortoiliofemoral Thromboendarterectomy vs Bypass Graft: A Randomized Study

Author Affiliations

Los Angeles
From the Department of General Surgery and the Vascular Surgery Service of the Los Angeles County-University of Southern California Medical Center and the University of Southern California School of Medicine, Los Angeles.

Arch Surg. 1972;105(6):898-901. doi:10.1001/archsurg.1972.04180120077014

Forty-three patients with aortoiliac arteriosclerosis were preoperatively assigned in random fashion, to a thromboendarterectomy (TEA) or a bypass graft (BPG) group without regard to the historical data, the preoperative aortograms, or the preoperative physical findings. Of 21 patients in the BPG group, the immediate success rate was 100% and all the patients left the hospital alive, though one died of an aortic suture line disruption six weeks postoperatively. Of 22 patients assigned to the TEA group, six required some form of BPG due to inability to complete TEA on one or both sides, an intraoperative failure rate of 27%. One patient in this group died postoperatively of renal failure. Aortoiliofemoral TEA and BPG are not comparable procedures. Anatomic factors and technical skill must be considered in choosing the proper operation.