[Iatrogenic injuries of the venous femoroiliac axis]. / Traumatismes iatrogènes de l'axe veineux fémoro-iliaque.

The occurrence of iatrogenous vascular accidents is underestimated. The authors describe 14 venous lesions to the femoro-iliac axis out of 60 iatrogenous vascular traumatisms. They consider the different aetiologies, underlining the disadvantages of femoral catheterisms and the main surgicalfactors contributing to venous traumatism. They emphasize the need for preventive measures in each discipline, and also the need for rapid diagnosis, thorough treatment, and careful post-operative after-care, bearing in mind secondary thrombo-embolic complications.

[180 aorto-bifemoral bypasses for chronic occlusive arteritis]. / Réflexions à propos de 180 pontages aorto-bifémoraux pour artéritechronique oblitérante.

In the authors' experience, 180 aorto-bifemoral by-pass grafts represent 42.4% of all reconstructive operations for aorto-iliac atheromatous disease performed between 1st January 1972 and 1st July 1983. 37% of the patients presented a threatened amputation and 38.8% had a walking distance of less than 100 metres. The immediate post-operative mortality (1st month) was 2.2% (4 patients). The 5 year survival, expressed according to the actuarial method, was 89% and the patency was 91%. The long-term functional deterioration was due to a progressive alteration of the distal vascular bed and to complications: false aneurysms (2.2%), prosthetic infections (1%), aorto-intestinal fistulae (2.2%), thrombosed prostheses (7.3%). 7 complementary femoro-popliteal by-pass grafts (4%) and 13 major amputations (7.4%) were required. The authors stress the value of performing end-to-end aortic anastomoses rather than side-to-end anastomoses. The anastomoses should be well isolated from the gastrointestinal tract. The patients should be rigorously followed post-operatively and any complication detected should be treated actively.