BACKGROUND: Extra-anatomical bypass, which is an alternative procedure to classical surgery, aims at simplifying a complex procedure such as aortoiliac reconstruction. OBJECTIVES: To analyze long-term outcomes of extra-anatomical bypass of the aortoiliac segment. METHODS: Longitudinal retrospective study including 79 extra-anatomical bypasses of the aortoiliac segment, performed in 75 patients between December 1991 and December 2006. RESULTS: Mean age was 64.2 years, and male gender was predominant (64%). Critical ischemia accounted for most indications for surgery (86.1%); crossover iliofemoral bypass represented 41.8% of all procedures. Mortality, patency and limb salvage rates were 28, 70.3 and 67.6%, respectively, at five years. CONCLUSIONS: Extra-anatomical bypasses should remain as alternative procedures because of their lower patency rates in comparison to anatomic procedures and considerable morbidity and mortality rates. However, they are important procedures when anatomic revascularization cannot be accomplished due to clinical and local limitations. Crossover bypasses demonstrated better patency rates than axillofemoral bypasses, and crossover iliofemoral bypasses showed the best patency rates of all (77.3% at five years).
Surgery; abdominal aorta; blood vessel prosthesis; amputation; mortality
