Thoracic aorta-femoral artery bypass: indications, technique, and late results

Retroperitoneal descending thoracic aorta-femoral artery bypass was performed in 18 patients over an 11-year period. The reconstruction was carried to both femoral arteries in 12 patients; in the other 6, only a single femoral artery was revascularized. The operative indication in Group 1 (3 patients) was infection of a previous aortoiliac reconstruction; in Group 2 (12 patients), occlusion of a previous aortoiliac reconstruction; and in Group 3 (3 patients), aortoiliac occlusive disease in which a direct transabdominal procedure was considered hazardous. Follow-up ranged from 6 months to 9 years (mean, 40 months). Cumulative patency rate was 96 +/- 3.9% at 1 year and 85 +/- 8.1% at 5 years. No alterations of serum creatinine and blood urea nitrogen values were recorded seven days and 6 months after operation. Retroperitoneal thoracic aorta-femoral artery bypass is a useful technique for accomplishing lower limb revascularization in patients in whom exposure or availability of the abdominal aorta poses a specific hazard.