• We measured the hemodynamic improvement after femorofemoral grafting and determined the five-year cumulative patency rate in 54 consecutive high-risk patients with unilateral iliac artery occlusion who had femorofemoral grafts who were studied with ankle and brachial systolic pressure measurements before and after operation and at six-month intervals. There were two early deaths and seven early graft failures (<30 days) with four amputations (all operated on for rest pain). All of the remaining 45 patients' conditions improved clinically and objectively. The resting pressure index (mean±SD) in claudicants (n=23) increased from 0.35±0.15 to 0.67±0.20; in patients with severe ischemia (n=31) it increased from 0.25±0.15 to 0.50±0.20. During the follow-up period (six months to ten years), there were eight deaths and 12 late graft failures (>30 days). The late cumulative patency rate was 60% at five years. Hemodynamic improvement parallels clinical success and for these high-risk patients, the femorofemoral bypass is a satisfactory alternative to a more major operation.
(Arch Surg 1985;120:1274-1278)