Early to mid-term outcomes of axillo-bifemoral bypass using T-shaped heparin-bonded expanded polytetrafluoroethylene grafts

Objectives

The aim of this study was to evaluate the early to mid-term outcomes of axillo-bifemoral bypass (AxBF) using T-shaped heparin-bonded expanded polytetrafluoroethylene (HB-ePTFE) grafts for bilateral aorto-iliac occlusive disease.

Materials and Methods

This was a retrospective, observational, and descriptive case series. Between February 2014 and October 2023, ten patients with abdominal aortic to iliac artery lesions underwent AxBF for bilateral aorto-iliac occlusive disease. Before June 2018, nine patients underwent aortic-bilateral femoral artery bypass (AoB) via the open abdomen approach for bilateral aorto-iliac occlusive disease. We investigated the reintervention rate, survival rate, and cause of death of the patients in the AxBF and AoB groups.

Results

During the observation period, reintervention was performed for other graft occlusions or residual lesions in more distal vessels in two patients in the AxBF group and for occlusion due to lower extremity thrombosis in one patient from the AoB group. These events were managed appropriately, with no procedure-related mortality.

Conclusion

AxBF using T-shaped HB-ePTFE grafts was technically feasible and performed safety, without procedure-related mortality, in this series of high-risk patients with bilateral aorto-iliac occlusive disease. These observations support the viability and perioperative safety of the approach. However, given the retrospective design, small sample size, and selective patient inclusion, these results should be interpreted as descriptive observations, and further prospective studies are warranted to confirm their clinical significance.