Evaluation of End-to-Side v End-to-End Proximal Anastomosis in Aortobifemoral Bypass

George E. Pierce, Mark Turrentine, Scott Stringfield, John Iliopoulos, Creighton A. Hardin, Arlo S. Hermreck, James H. Thomas

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Abstract

The cumulative graft-limb patency rate was significantly higher after aortobifemoral bypass with a proximal end-to-end anastomosis (E-E-AN) than with a proximal end-to-side anastomosis (E-S-AN), 100% v 93%, respectively, after 1.5 years in a consecutive series of 38 E-S-ANs followed by 41 E-E-ANs. The two operations were equally effective in relieving hip claudication, but impotence occurred more frequently after E-E-AN (27%) than after E-S-AN (13%). This difference was not significant, but six of ten patients with E-E-AN who became impotent had arteriographic patterns predicting that graft flow into hypogastric arteries might be compromised. Intraoperative studies demonstrated that acute bilateral occlusion of hypogastric arteries significantly decreases penile BP, but branches of the external iliac arteries also contribute to penile flow and may become the major route of supply in patients with hypogastric occlusive disease.

Original languageEnglish (US)
Pages (from-to)1580-1588
Number of pages9
JournalArchives of Surgery
Volume117
Issue number12
DOIs
StatePublished - Dec 1982

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ASJC Scopus subject areas

  • Surgery

Cite this

Pierce, G. E., Turrentine, M., Stringfield, S., Iliopoulos, J., Hardin, C. A., Hermreck, A. S., & Thomas, J. H. (1982). Evaluation of End-to-Side v End-to-End Proximal Anastomosis in Aortobifemoral Bypass. Archives of Surgery, 117(12), 1580-1588. https://doi.org/10.1001/archsurg.1982.01380360056009