Late iliac artery aneurysms and occlusive disease after aortic tube grafts for abdominal aortic aneurysm repair: A 35-year experience

David Calcagno, John W. Hallett, David J. Ballard, James M. Naessens, Kenneth J. Cherry, Peter Gloviczki, Peter C. Pairolero

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Controversy continues over whether patients treated with straight Dacron aortic tube grafts for an abdominal aortic aneurysm remain at significant risk for subsequent development of iliac aneurysm or occlusive disease. To address this issue, the authors performed a population-based analysis of 432 patients who had an abdominal aortic aneurysm diagnosed between 1951 and 1984. Aneurysm repair was performed eventually in 206 patients (48%). To ascertain differences in late development of graft-related complications, iliac aneurysms, and arterial occlusions, the authors compared all tube-graft patients with similar numbers of bifurcated-graft patients matched for age and year of operation. In the tube-graft group, no subsequent clinically evident or autopsy-proven iliac aneurysms or iliac occlusive disease were noted. Over a mean follow-up of 6 years (range, 4 to 18 years), new aortic aneurysms occurred in the proximal aorta in both tube and bifurcated-graft patients (5.0% and 2.5%, respectively). In contrast the cumulative incidence of graft-related complications was higher with a bifurcated prosthesis (12.8%) compared with a straight graft (5.0%) (p = 0.15). These problems generally occurred 5 to 15 years postoperatively and emphasize the need for long-term graft surveillance. The authors conclude that straight tube-grafts for repair of abdominal aortic aneurysms provide excellent late patency with minimal risk of subsequent iliac aneurysm development.

Original languageEnglish (US)
Pages (from-to)733-736
Number of pages4
JournalAnnals of surgery
Volume214
Issue number6
DOIs
StatePublished - Dec 1991

ASJC Scopus subject areas

  • Surgery

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