THE RISK OF DEVELOPMENT OF ANASTOMOTIC AN EURYSM AND GRAFT INFECTION AFTER AORTOFEMORAL BYPASS GRAFT - A RETROSPECTIVE STUDY OF 211 CASES

Anastomotic aneurysm and infection of arterial graft are complications that occur late after aorto-femoral bypass graft surgery. The objecti ve of this paper is to calculate the percentage of patients free of th ese complications after 10 years. From 1966 to 1983, 211 patients were operated on consecutively to treat aortoiliac atherosclerotic obstruc tive disease. There were 173 (82 %) men and 38 (18 %) women of mean ag e 54.7 +/- 9.1 years. Forty-one percent of patients were operated on f or limb salvage. Aorto-bi-femoral bypass was performed in 196 (92.9 %) patients; the unilateral aorto-femoral bypass in 8 (3.8 %) and the ao rto-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 (2 1 patients) or reconstruction of visceral arteries (7 patients). The a nastomosis was end-to-side both in the aorta and in the femoral arteri es, made of synthetic sutures. Diagnosis of the complications was made by physical examination, ultrasonography, CT scan or arteriography. T he Kaplan-Meier method was used to determine the percentage of patient s without complications. After 24, 60 and 120 months, 98.5 %, 92.6 % a nd 85.4 % of the patients were free of anastomotic aneurysm, respectiv ely and after the same periods, 97.3 %, 90.4 % and 75.2 % of the patie nts res pectively were free of graft infection (table 2). We conclude that the risk of developing complications is a permanent risk and incr eases with time, but the use of grafts cannot be invalidated (J Mal Va sc 1996; 21 : pages 36-39).