[Long-term results 10-14 years following implantation of Y-prostheses for arterial occlusive disease].
Between 1973 and 1977 169 patients underwent implantation of bifurcated prostheses for arterial occlusive disease. Perioperative and follow-up data 10-14 years after operation were retrospectively assessed. The angiologic status of living patients was compiled. Impact of following risk factors was investigated with multivariant analysis. Coronary artery disease, hypertension, smoking, diabetes mellitus, Pulmonary disease, renal insufficiency, obesity. Follow-up was 98.8%. Preoperatively over 90% of the patients investigated had been in grade IIb (Fontaine) or worse (33% grade IV). Early mortality was 5.3% (1973 = 15%, 1977 = 5.3%, 1987/1988 = 1.8%) and was mainly related to cardiopulmonary factors. Reoperation was necessary in 69 patients (149 procedures, no mortality, 38 amputations). Late mortality was 75% (120 of 160 patients) and mainly due to cardiac problems. The 10-year-actuarial-survival (37%) was reduced due to following combinations of risk factors: Myocardial infarction/smoking/obesity (n = 41) 17%, diabetes/smoking (n = 36) 17% hypertension/myocardial infarction (n = 24) 8%. Clinical condition of the living patients (n = 40) was: 48% grade I, 28% grade IIa, 18% grade IIb, none grade III, 8% grade IV. Long term results following implantation of bifurcated prostheses for arterial occlusive disease show, that quality of life is consistently improved. Reoperation is necessary in almost half of the patients due to the progressive disease. Late mortality is closely related to the underlying arteriosclerosis. Life expectancy of our patients does not significantly differ from the normal population and is probably a sequelae of the close follow-up.
Albes
J M
JM
Abteilung für Thorax-, Herz- und Gefässchirurgie, Medizinische Hochschule Hannover.
Ladendorff
V
V
Alexander
K
K
Laas
J
J
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011474:Prosthesis Design; D012189:Retrospective Studies