Postoperative physiologic data were reviewed in 74 patients with 85 femoropopliteal bypass grafts. Documented progression of atherosclerosis occurred in the aortoiliac segment in 18 limbs and in the popliteal and tibioperoneal vessels in 14 limbs, although aortoiliac disease was more often responsible for graft failure. Grafts with good postoperative runoff as determined by hemodynamic measurements had a statistically significant higher patency rate than those with poor runoff. Nearly half of the limbs with a progressive postoperative decline in the ankle-arm index ultimately had graft occlusion. Rapid progression of popliteal artery atherosclerosis distal to an above-knee graft was not a significant problem.

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