Long-term outcome of aortofemoral bypass for aortoiliac occlusive disease.
BACKGROUND
Revascularisation of aortoiliac occlusive disease has been evolving in the past 2 decades. The present study was undertaken to evaluate the long-term outcomes of aortofemoral bypass for aortoiliac occlusive disease at a tertiary vascular disease centre in Hong Kong.


METHODS
A retrospective analysis of 94 patients (176 limbs) who survived aortofemoral bypass was performed to evaluate the graft patency, long-term complications, limb loss and patient survival rates. Thirty-six patients were operated for incapacitating claudication (Group I) and 58 for limb salvage (Group II).


RESULTS
The overall primary patency rates of aortofemoral bypass were 97%, 90%, 89% and 84% at 1, 3, 5 and 10 years, respectively. Poor distal run-off and neointimal hyperplasia were the leading causes of late graft failure. Other late complications included femoral pseudoaneurysm (n = 1), infection (n = 1) and femoral graft aneurysms (n = 2). The limb loss rate was 5.1% at 4 years. The overall survival rates were 95%, 86%, 81% and 75% at 1, 3, 5 and 10 years, respectively. Ischaemic heart disease and malignancy were the 2 major causes of late death. The 5-year survival rate of group I patients (96%) was significantly superior to that of group II patients (70%).


CONCLUSIONS
Aortofemoral bypass achieved a primary patency rate of 89% at 5 years and a satisfactory limb salvage rate. It remains the preferred treatment option for good risk patients with complete occlusion or extensive stenosis of the aortoiliac arteries.
Lau
H
H
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, SAR China. hklauh@netscape.net
Cheng
S W
SW
D001018:Aortic Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007083:Iliac Artery; D007383:Intermittent Claudication / Q000209:etiology; D015424:Reperfusion / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D014654:Vascular Patency