The fate of the aortofemoral graft

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