Changing patterns in aortoiliac reconstruction: a 7-year audit.
A prospective vascular audit was performed in this hospital between 1988 and 1994. There was a substantial increase in the number of vascular reconstructions (78 in 1988; 141 in 1994). Aortobifemoral grafts for occlusive disease comprised 18 per cent of the operations in 1988 and 0.7 per cent in 1994 (95 per cent confidence interval 0.086-0.259). There was a corresponding increase in the number of extra-anatomic grafts (from 3 to 20.6 per cent). There was a threefold increase in the number of percutaneous angioplasties performed for iliac occlusive lesions (14 in 1988; 41 plus 13 iliac stent procedures in 1994). This had no impact on the total rate of surgical intervention for aortoiliac disease, although it probably aided the shift to extra-anatomic reconstruction by dilatation of the donor side. To investigate whether this change is national, rather than local, graft sales figures were obtained from two vascular graft companies; these confirmed a national trend away from aortobifemoral grafting and provide some evidence to support an increase in extra-anatomic bypass grafting.
Whiteley
M S
MS
Department of Surgery, Royal Berkshire Hospital, Reading, UK.
Ray-Chaudhuri
S B
SB
Galland
R B
RB
D017130:Angioplasty; D001018:Aortic Diseases / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004739:England; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008485:Medical Audit; D011446:Prospective Studies; D015607:Stents; D013518:Surgery, Plastic