Late reintervention for aortic graft-related events and new aortoiliac disease after open abdominal aortic aneurysm repair in an Australian population.
OBJECTIVE
To examine late reintervention rates for aortic graft-related events and new aortoiliac disease after open abdominal aortic aneurysm (AAA) repair in an Australian population.


METHODS
Interrogation of a prospective computerized database identified 1256 consecutive patients (1058 men, 198 women; median age, 70 years; range, 40 to 97 years) who survived open repair of nonruptured (n = 957, group I) and ruptured (n = 299, group II) infrarenal AAA in a single institution between January 1, 1982 and December 31, 2003. Median (range) follow-up was 41 (1 to 261) months for group I and 30 (1 to 243) months for group II.


RESULTS
In group I, 33 patients (3.4%) underwent 38 late reinterventions: 20 patients (2.1%) for aortic graft-related events at a median (range) interval of 36 (1 to 94) months after the index AAA repair, with a 30-day mortality rate of 15%; and 13 patients (1.4%) for new aortoiliac disease at a median (range) interval of 33 (3 to 207) months, with 30-day mortality of 8%. In group II, 15 patients (5%) underwent 16 late reinterventions: 10 patients (3.3%) for aortic graft-related events at a median (range) interval of 5 (2 to 112) months, with a 30-day mortality of 10%; and five patients (1.7%) for new aortoiliac disease at a median (range) interval of 67 (39-105) months, with a 30-day mortality of 40%. There was no significant difference in the late reintervention rate between the groups: group I, 33 (3.4%) of 957 vs group II, 15 (5%) of 299 (P = .23). For all patients, the estimated survival at 1, 3, 5 and 10-years was 90%, 79.4%, 66.4%, and 31.6%, respectively; estimated survival free from reintervention at 1, 3, 5 and 10-years was 98.7%, 97.1%, 95.1%, and 91.9%, respectively.


CONCLUSIONS
These data demonstrate, for the first time, that open AAA repair has excellent long-term durability in an Australian population and the results compare favorably with previous reports from North America and Europe. These data represent an important benchmark for comparison of the results of endovascular AAA repair in this patient population.
Adam
Donald J
DJ
University Department of Vascular Surgery, Birmingham Heartlands Hospital, Research Institute Lincoln House, Bordesley Green East, Birmingham, United Kingdom. Donald.Adam@heartofengland.nhs.uk
Fitridge
Robert A
RA
Raptis
Spero
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D001027:Aortography; D001315:Australia; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011336:Probability; D011446:Prospective Studies; D011475:Prosthesis Failure; D012042:Registries; D012086:Reoperation; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors