title: Chronic infrarenal aortic occlusion: predictors of surgical outcome in patients undergoing aortobifemoral bypass reconstruction.
abstract: OBJECTIVE
  Chronic infrarenal aortic occlusion is relatively infrequent. Aortobifemoral bypass has been the traditional treatment. The aim of this study is to evaluate the prognostic factors related to long-term survival and patency rates of chronic infrarenal aortic occlusion after aortobifemoral bypass.
  
  
  METHODS
  From January 1984 to December 2004, we performed consecutively 278 aortobifemoral for aortoiliac occlusive disease. Of these, 67 (24%) patients, 62 men (92.5%), presented with ischemia due to aortic occlusion. The log-Rank test was used to determine predictors of long-term survival and graft patency in a univariate analysis. With a model of proportional-hazards Cox regression the independent prognostic factors of long-term survival were determined.
  
  
  RESULTS
  The postoperative mortality was 8.9%. The estimated cumulative long-term survival for aortic occlusion patients was 56% and 38% at 10 and 20 years, respectively. The estimated cumulative primary patency was 79% at 10 years and 40% at 20 years. The 20-year limb survival rate was 86%. There was no statistical difference in long-term survival and graft patency between TASCIC-D and IRAO. Previous coronary disease (P=0.008) and postoperative complications (P=0.017) significantly decreased the survival of patients. Both variables retained significance on multivariable analysis. The presence of chronic renal failure significantly decreased the patency of the aortobifemoral bypass (P=0.013).
  
  
  CONCLUSIONS
  Aortobifemoral bypass for chronic infrarenal aortic occlusion has an excellent primary patency rate with reasonable morbi-mortality. The presence of concomitant coronary disease and postoperative complications are prognostic factors of long-term survival.
authors.affiliation: Department of Vascular Surgery, University Hospital Dr. Negrín, Las Palmas de Gran Canaria, Canary Island, Spain. pakigf@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: García-Fernández
authors.forename: J
authors.initials: J
authors.lastname: Marchena Gómez
authors.forename: V
authors.initials: V
authors.lastname: Cabrera Morán
authors.forename: M
authors.initials: M
authors.lastname: Hermida
authors.forename: E
authors.initials: E
authors.lastname: Sotgiu
authors.forename: G
authors.initials: G
authors.lastname: Volo Pérez
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001012:Aorta, Abdominal / Q000503:physiopathology / Q000601:surgery*; D001018:Aortic Diseases / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000150:complications; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency