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Late reoperations after surgical and endovascular lower limb revascularisation
P Desgranges1, J Cron, E Allaire
1Vascular Surgery Unit, Hôpital Henri Mondor, France.
Objectives:
to evaluate the rate of late reoperations after primary lower limb revascularisation.
Methods:
a prospectively collected database of 639 consecutive patients, undergoing 763 primary arterial reconstruction for lower limb occlusive disease during the five-year period 1989 through 1993, was analysed with regard to the rates and locations of late (after 30 days) re-operation. The reconstruction was supra-inguinal in 527 (69%) cases, surgical in 391 (Group IA) and endovascular in 136 (Group IB). Infra-inguinal reconstruction had been performed in 236 (31%) cases, surgical in 160 (Group IIA) and endovascular in 76 (Group IIB). The 499 men and 140 women were followed during an average of 32 (range 1-122) months.
Results:
the 5-year cumulative reoperation rates were 25% after supra-inguinal surgery and 28% after supra-inguinal angioplasty, respectively (NS). The rates were 47% and 33% after infra-inguinal surgery and angioplasty, respectively ( p=0.04).
Conclusion:
limbs treated for occlusive arterial disease carry a high risk of late reoperation whether the initial procedure is open surgery or angioplasty. Reoperations were twice as common for infra-inguinal procedures.