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Axillary-Popliteal Artery Bypass Provides Successful Limb Salvage After Removal of Infected Aortofemoral Grafts

Walter J. McCarthy, MD; Gregory S. McGee, MD; William W. Lin; William H. Pearce, MD; William R. Flinn, MD; James S. T. Yao, MD, PhD
Arch Surg. 1992;127(8):974-978. doi:10.1001/archsurg.1992.01420080108018.
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• Axillary-popliteal artery bypasses were placed to revascularize 28 extremities for 17 patients who were undergoing removal of infected aortofemoral grafts. Polytetrafluoroethylene (PTFE [polytef] material was anastomosed to the above-knee popliteal artery in 22 cases and to the below-knee popliteal artery in six limbs. All but one patient had axillary-popliteal grafts in place before excision of the aortic graft. In 12 groins, vein-patch angioplasty was performed after removal of the infected aortic graft to provide retrograde pelvic perfusion and maintain femoral patency for future reconstruction. Three patients (18%) died of septic-related, multisystem organ failure. With a mean follow-up of 25 months, primary patency was 75% at 1 year and 43% at 2 years. Secondary patency, maintained by thrombectomy (n=7), revision (n=3), and conversion to warfarin sodium (Coumadin) therapy (n=6) was 100% at 2 years, and limb salvage was achieved for all surviving patients.

(Arch Surg. 1992;127:974-978)


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