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Aortic grafting procedures: tailoring the options.

Records from 165 patients who had received aortoiliac or aortofemoral bypass grafts were reviewed. The overall five-year patency rate was 88%. There was no significant difference in operative duration, amount of blood transfused, postoperative complications, and life table patency rates when comparisons were made of unilateral and bilateral grafts, of patients who underwent sympathectomy and those who did not, or of aortofemoral and aortoiliac grafts. When bypass grafting included an additional procedure, the amount of blood transfused and the number of postoperative complications increased significantly. We conclude that (1) the decision to operate should be based on symptoms, (2) the site of anastomosis should be chosen from anatomic characteristics, and (3) other procedures should not be performed except to achieve obvious therapeutic goals and to assure graft patency.