Axillo-bifemoral Bypass as a Treatment Alternative: a Decade of Experience at the Ernesto Guevara Cardiocentre

Abstract

Introduction: The axillo-bifemoral bypass is an extra-anatomical revascularization technique indicated for patients with complex aorto-iliac lesions who are at high surgical risk.

Objective: To analyze the clinical characteristics and short- and long-term outcomes of patients who underwent axillobifemoral bypass at the Vascular Surgery Department of the Ernesto Che Guevara Cardiocentro.

Methods: A retrospective, descriptive, observational cohort study was conducted, including all patients who underwent axillobifemoral bypass between 2014 and 2024. Epidemiological variables, comorbidities, indications for surgery, complications, and cumulative patency rates (early and at 10 years) were analyzed.

Results: A total of 61 patients (57.3% men) underwent surgery, with a mean age of 63.9 years. The main comorbidities were COPD (65.5%) and ischemic heart disease (60.6%). The most common indication was TASC D aorto-ilio-femoral occlusion (54.1%). The primary patency rate at one year was 86.8%, and the cumulative patency rate at 10 years was 81.1%. Perioperative mortality (30 days) was 4.9%.

Conclusions: The axillobifemoral bypass is a useful, safe technique with acceptable long-term patency results in appropriately selected high-risk patients and constitutes a valid alternative when anatomical surgery is contraindicated.