Association between the number of vascular operation on the lower limbs and long term survival

To investigate to what extent the need for more than one vascular operation for chronic lower limb ischaemia was associated with relative long term survival.

Retrospective observational study.

University hospital, Norway.

1574 patients (29% women) operated on for chronic lower limb arterial insufficiency. Of these 447 needed at least one further operation for progressive limb ischaemia.

Long term survival estimated by the Kaplan-Meier method. The expected survival was calculated from mortality tables issued by the Norwegian Central Bureau of Statistics.

The 10-year survival rate was 46% for the patients operated on once and 24% for the patients who had two or more operations. The expected survival rates were 57% and 52%, respectively. Both categories of patients had significantly shorter long term survival than a demographically-matched population. The long term survival of patients operated on twice or more was significantly less than that of those who needed only one operation.

There is an association between the need for more than one vascular operation and long-term survival. Atherosclerotic disease among these patients seems to be more aggressive.