Pelvic Blood Flow Following Aortobifemoral Bypass with Proximal End-to-Side Anastomosis

Susan E. O'Connor*, Daniel B. Walsh, Robert M. Zwolak, Joseph R. Schneider, Jack L. Cronenwett

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Nine patients with end-to-side aortobifemoral bypasses were studied in the first year after surgery using color duplex imaging to determine the source of pelvic blood flow. No patient had clinical evidence of postoperative pelvic ischemia. Six of nine patients were found to have occluded distal aortas by duplex studies performed at a mean of 4.4 months postoperatively (range 0.8–8.2 months). Of those six patients, postoperative duplex examination demonstrated two with no common or external iliac blood flow, two with bilateral retrograde external iliac flow, and two with unilateral retrograde external iliac flow. Of the three patients with patent distal aortas, two had no demonstrable external iliac blood flow, while the third had continued antegrade flow through one external iliac and retrograde flow through the other. Analysis of preoperative arteriograms failed to reveal accurate predictors of postoperative distal aortic patency or retrograde iliac blood flow. Despite the preoperative assumption that prograde common iliac artery blood was required to prevent pelvic ischemia, distal aortic patency was maintained in only three of nine patients. In the six patients with prograde iliac blood flow, no ischemic symptoms were present, including two patients with complete absence of antegrade aortic or retrograde external iliac blood flow. Our observations indicate that assumptions which underlie the decision to perform end-to-side aortic anastomoses are often not borne out in the months following aortobifemoral bypass.

Original languageEnglish (US)
Pages (from-to)493-498
Number of pages6
JournalAnnals of vascular surgery
Volume6
Issue number6
DOIs
StatePublished - Jan 1 1992

Keywords

  • Aortobifemoral bypass
  • aorta
  • aortoiliac disease
  • iliac arteries
  • pelvic ischemia

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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