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The fate of the aortofemoral graft
1University of Adelaide, Vascular Surgery Unit, Royal Adelaide Hospital, Australia.
Objective:
To determine the incidence and cause for reoperation following aortofemoral bypass surgery.
Design:
This paper describes the results of all aortofemoral grafts performed in the years 1978-1991, 251 of these patients underwent an aortobifemoral graft (ABF) whilst the remaining 50 had an aortounifemoral graft (AUF).
Results:
The aortofemoral bypass was the only operation performed in fewer than half of the patients. Sixteen per cent of ABF and 50% of the AUF patients had surgery before the index operation. Subsequently 33% of the ABF patients and 60% of the AUF group had one or more additional vascular procedures. Graft infections and false aneurysms continued to present in about 1% patients per year at least up to 10 years following surgery. The 5 year actuarial survival was 73% in the ABF group and 38% in the AUF patients. The primary patency at 5 years was 85% in the ABF patients and 81% in the AUF group. Amputation was performed in 6% of the ABF patients and in 20% of the AUF patients.
Conclusions:
The frequent need for later surgery (1:3 for the ABF patients) should be considered in the decision to undertake the initial aortofemoral operation when the patient presents with intermittent claudication.