Analytical and experimental evidence to invalidate the cross-over femoral "steal phenomena" in unilateral ilio-femoral disease

Cross-over ilio-femoral grafts were implanted in 15 mongrel dogs and blood flow studies carried out to determine whether cross-over "steal" occurred when the graft was opened to allow blood to flow from a healthy donor right ilio-femoral circulation to an artificially stenosed left ilio-femoral system. The magnitude of the "steal" was also predicted from an analog model of the bilateral ilio-femoral system and cross-over graft in the form of an electrical equivalent circuit. Both the surgical preparation and the electrical model gave similar results for "steal", both indicating a "steal" of less than 5%. These results were obtained for a range of the ratio of left to right total peripheral resistances of 0.79-1.04 for the experimental model and 0.5-1.5 for the analog model. It was concluded that the procedure of using cross-over grafting from a donor ilio-femoral system to an ischemic ilio-femoral circulation does not lead to significant "steal" of blood from the donor femoral artery if the donor artery is not stenotic.