Autogenous venous grafts ten years later

Abstract

The status of 103 patients and their 113 autogenous venous femoropopliteal bypass grafts exactly 5 years after operation was presented previously. A 10 year follow-up now is possible. The mortality rate at 5 years was 48% (50 of 103) and at 10 years was 73% (75 of 103). Myocardial infarction was considered to be the cause of death of 36% of the 103 patients. The actual graft patency rate for survivors at 5 years was 59% (35 of 59) and at 10 years was 38% (11 of 29). Utilizing the same date, late graft patency rates of 45%, 58%, and 58% would have been calculated or predicted by other methods of reporting. Of 46 extremities operated on for claudication, 22 patients were alive and 45% of grafts (10 of 22) were patent 10 years later. Of patients with a total of 67 extremities operated on for rest pain or gangrene, only seven patients were alive and 14% (one of seven) of the grafts patent. Patency rates at 10 years of short grafts were 43% (nine of 21) and of long grafts 25% (two of eight). Extremities with good runoff had patency rates of 41% (nine of 22) at 10 years and those with poor runoff had patency rates of 29% (two of seven). Arteriograms demonstrated atherosclerotic changes in one of 18 grafts at 5 years and in two of eight grafts at 10 years. This study provides more facts for answering the questions of patients regarding long-term prognosis following their arterial reconstruction. It is important to analyze carefully any report in which a comparison of patency rates is suggested or invited.