[False aneurysm after reconstruction for peripheral arterial occlusive disease. Observations over 15 to 25 years]

In an earlier study patients operated for arterial occlusive disease have been observed for at least 15 to 25 years. They have now been analysed for incidence, localization, time of appearance and results of reoperation of anastomotic aneurysms. These are not only seen after prosthetic bypass--2/3 of 27 cases--with an incidence of 7.8%, but also after vein bypass (5.23%), semiclosed endarterectomy with dacron patch (2.59%) or vein patch (5.23%) and open endarterectomy with vein patch (7.14%). The incidence depends mainly upon the time of observation. They appear in the inguinal area in 38.5%, near the adductor canal in 27%, above the inguina in 19% and below the knee in 15%. They have to be expected earlier with prosthetic bypass. Mortality after reoperation is higher with aortoduodenal fistula (18.75%) than without (7.14%). The postoperative patency rate was about 65%, amputation occurred only after prosthetic bypass as primary procedure. The patency rate was 80% after 1 year, remained at this level so after endarterectomy for 10 years and dropped after prosthetic bypass after 4 years considerably, leading to a high amputation rate within 15 years. Up to 10 years most of the patients who died in the later period had an open reconstruction at death and had up to that time no walking problems. Death was due to coronary heart disease in 55.5% and cancer of the lung in 22.2%.