ABSTRACT
The purpose of this study is to clarify the appropriateness of axillofemoral bypass for high-risk patients with aortoiliac occlusive disease. From February 1986 through November 1997, 50 axillofemoral bypasses were performed at our institution. The mean age of patients was 70.3± 9.6 years (range 28 to 86 years) and 90% of them had severe associated disease. Twenty-nine grafts had axillounifemoral configuration and 21 grafts had axillobifemoral configuration. The primary and secondary patency rate, during this 11-year period (mean follow-up 47.0±30.1months), were 66.4 % and 78.3% at 5 years, with no change thereafter. The mortality rate within 30days was 2%. During the follow-up period 22 died mainly due to heart disease, cerebrovascular disease or malignant tumor, and the survival rate at 5 years was 56.3%. Fontaine classification evaluation revealed that ischemic symptoms improved in 78% of 28 survivors. According to QOL study 75% of survivors were satisfied with daily life, and their performance status improved after operation. These findings indicate that axillofemoral bypass may be an appropriate procedure for high risk patients with aortoiliac occlusive disease.