Differences in results for aneurysm vs occlusive disease after bifurcation grafts: results of 100 elective grafts.

To compare abdomonal aortic surgery for aneurysmal (AAA) vs occlusive (OCC) disease, 50 consecutive cases of elective bifurcation grafts for AAA and 50 consecutive cases for OCC disease were analyzed. The mean age of the AAA patients was a decade greater than the OCC patients, and they had more associated diseases. Only six AAA patients were women, while women predominated in the OCC group. Only three AAA patients were claudicants and none had rest pain. About one third of the OCC group had distal disease, and 14 had rest pain. Operative mortality was 4% (two deaths in each group). The survival of the grafted AAA patients was almost equal to normal expectancy. There were no late thromboses of grafts in the AAA group, while there were five late failures in the OCC group. The OCC group underwent significantly more frequent reoperative surgery during the follow-up period. The numerous differences in the two population groups apparent in this study provide a basis for questioning the concept that aneurysms are caused by atherosclerosis.