Aortofemoral dacron reconstruction for aorto-iliac occlusive disease: a 25-year survey.

The authors present a consecutive series of 869 patients, who received an aorto(bi)femoral Dacron graft for occlusive disease between 1963 and 1988. The operative indications were grade 1 disease (n = 371), grade 2 disease (n = 408) or grade 3 disease (n = 90). The operative mortality was 4.5% and remained stable over the years of the study. The median survival was 8.2 years and 25% of the patients survived for more than 15 years. Late patency decreased to 74% and 70% after 10 and 15 years, respectively. Fifty-six patients underwent a major amputation in the long run. The amputation rate increased to 3, 8.6 and 12.1%, respectively for grade 1, grade 2 and grade 3 disease. Satisfactory functional results were obtained by 51% and 40% of the patients after 10 and 15 years, respectively. By means of secondary and tertiary operations this increased to 70% and 61%. Long term functional results were primarily dependent on smoking habits postoperatively, the date of operation and the presence of concomitant femoro-popliteal occlusive disease.