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Long-term results of 44 cross-over bypasses.

Forty-four patients with an unilateral iliac obstruction were treated with a cross-over bypass. The ASPI at rest in the recipient leg was 0.53 +/- 0.16 pre-operatively and had increased to 0.82 +/- 0.13 3 months after operation (p less than 0.001). One patient died within 30 days of operation and in another graft thrombosis occurred within this period. In 2 patients above-knee amputation had to be performed owing to graft failure. During the follow-up period (3 months to 10 years) 9 patients died and 8 late graft failures (30 days) occurred without limb loss. The cumulative patency rate amounted to 73.7% after 5 years. A significant steal effect could not be demonstrated. The cross-over bypass is a procedure justified in unilateral iliac occlusion in high- and moderate risk patients with intermittent claudication and pain at rest or gangrene.