[Risk of development of false aneurysm and graft infection after aorta-femoral bypass graft. Retrospective study....

Anastomotic aneurysm and infection of arterial graft are complications that occur late after aorto-femoral bypass graft surgery. The objective of this paper is to calculate the percentage of patients free of these complications after 10 years. From 1966 to 1983, 211 patients were operated on consecutively to treat aortoiliac atherosclerotic obstructive disease. There were 173 (82%) men and 38 (18%) women of mean age 54.7 +/- 9.1 years. Forty-one percent of patients were operated on for limb salvage. Aorto-bi-femoral bypass was performed in 196 (92.9%) patients; the unilateral aorto-femoral bypass in 8 (3.8%) and the aorto-femoral to one side and aorto-iliac to the order in 7 (3.3%). In 28 patients, the bypass was associated with femoro-popliteal bypass (21 patients) or reconstruction of visceral arteries (7 patients). The anastomosis was end-to-side both in the aorta and in the femoral arteries, made of synthetic sutures. Diagnosis of the complications was made by physical examination, ultrasonography, CT scan or arteriography. The Kaplan-Meier method was used to determine the percentage of patients without complications. After 24, 60 and 120 months, 98.5%, 92.6% and 85.4% of the patients were free of anastomotic aneurysm, respectively and after the same periods, 97.3%, 90.4% and 75.2% of the patients respectively were free of graft infection (table 2). We conclude that the risk of developing complications is a permanent risk and increases with time, but the use of grafts cannot be invalidated.