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Comparison of early and late postoperative outcomes after supra-inguinal bypass for aortoiliac occlusive disease

European Journal of Vascular and Endovascular Surgery Aug 27, 2019

Saadeddin ZM, Rybin DV, Doros G, et al. - In view of the observation that patient comorbidities often temper the choice for surgical revascularisation for aortoiliac occlusive disease, researchers compared perioperative outcomes and the association between choice of operation. Further, they investigated 1-year major adverse limb event free survival and 5-year mortality. Investigating the Vascular Study Group of New England dataset, they identified 1,602 eligible cases who underwent supra-inguinal bypass operations: 207 (12.9%) underwent axillofemoral (AXB); 872 (54.4%) aortofemoral (AFB); 523 (32.6%) femorofemoral. As per outcomes, significantly lower rates of postoperative complications were evident with FFB vs AXB. In high-risk patients with extensive disease, who cannot undergo AFB, FFB could serve as the extra-anatomical operation of choice, provided that anatomy permits. They recommend preferring performing AFB in low-risk patients with appropriate anatomy and suggest limiting AXB to patients with no other option for revascularisation owing to its higher complications rates.
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