Mortality risks for survivors of vascular reconstructive procedures

Abstract

Aneurysmal disease and occlusive disease may imply different risks of hastened death. In our opinion the aortoiliac site is more favorable than the femoropopliteal site in regard to the patient's age at operation and long-term survival. A follow-up study was done of 320 patients who survived aortic aneurysm repair, 212 patients who survived aortic bypass procedures, and 203 who survived femoropopliteal bypass procedures. The median ages at the time of operation were 66, 57, and 62 years, respectively. Median years of survival for the three groups were 5.8, 10.7, and 7.2 years, respectively. The difference for survival between patients with aortoiliac occlusive disease versus those with aneurysmal disease was statistically significant, as was the difference between occlusive disease in the aortoiliac segment versus the femoropopliteal segment. The difference in median survival of patients with aortic aneurysmal disease versus those with femoropopliteal disease was not significant. White men constituted the largest group of patients. When the median years of survival for different operations in white men were stratified into 5-year age groups according to age at operation, there was no significant difference between any operations within any of the age groups. (The older subgroups were too small for meaningful analysis). This suggests that the longer median survival for aortoiliac occlusive disease can be explained by the apparently younger median age at the time of operation.