Association between the number of vascular operation on the lower limbs and long term survival

Objective: To investigate to what extent the need for more than one vascula r operation for chronic lower limb ischaemia was associated with relative l ong term survival. Design: Retrospective observational study. Setting: University hospital, Norway. Subjects: 1574 patients (29% women) operated on for chronic lower limb arte rial insufficiency. Of these 447 needed at feast one further operation for progressive limb ischaemia. Main outcome measures: Long term survival estimated by the Kaplan-Meier met hod. The expected survival was calculated from mortality tables issued by t he Norwegian Central Bureau of Statistics. Results: The 10-year survival rate was 46% for the patients operated on onc e and 24% for the patients who had two or more operations. The expected sur vival rates were 57% and 52%, respectively. Both categories of patients had significantly shorter long term survival than a demographically-matched po pulation. The long term survival of patients operated on twice or more was significantly less than that of those who needed only one operation. Conclusion: There is an association between the need for mon than one vascu lar operation and long-term survival. Atherosclerotic disease among these p atients seems to be more aggressive.