THE FATE OF THE AORTOFEMORAL GRAFT

Objective: To determine the incidence and cause for reoperation follow ing aortofemoral bypass surgery. Design: This paper describes the resu lts of all aortofemoral grafts performed in the years 1978-1991, 251 o f these patients underwent an aortobifemoral graft (ABF) whilst the re maining 50 had an aortounifemoral graft (AUF). Results: The aortofemor al bypass was the only operation performed in fewer than half of the p atients. Sixteen per cent of ABF and 50% of the AUF patients had surge ry before the index operation. Subsequently 33% of the ABF patients an d 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 ye ar actuarial survival was 73% in the ABF group and 38% in the AUF pati ents. The primary patency at 5 years was 85% in the ABF patients and 8 1% in the AUF group. Amputation was performed in 6% of the ABF patient s and in 20% of the AUF patients. Conclusions: The frequent need for l ater surgery (1:3 for the ABF patients) should be considered in the de cision to undertake the initial aortofemoral operation when the patien t presents with intermittent claudication.