Late reoperation in vascular surgery

Abstract

Objectives: Assessment of late reoperation (after 30 days) following vascular surgery.

Design: Analysis of a prospectively collected database of consecutive patients undergoing vascular surgery.

Setting: A single teaching unit's experience between 1986-1993.

Materials: Patients undergoing 2501 primary arterial reconstructions.

Chief outcome measures: Reoperation after 30 days.

Main results: One hundred and fifty eight patients (6%) underwent further operations, at more than 1 month after the primary procedure. Primary procedures at highest risk for reoperations were axillobifemoral bypasses and femorodistal bypasses with respective late reoperation rates of 20% and 16%. The majority of patients required late reoperation because of graft occlusion or stenosis. Overall, of the 158 late reoperations performed, 114 were related to the same arterial segment with the same presenting symptoms as the primary operation, and 44 for a different indication. A second or subsequent reoperation was required in 54 patients and the overall operative mortality was 11%.

Conclusion: Patients undergoing certain vascular procedures, should be informed of the high risk of a subsequent procedure when consent is obtained.