Aortoiliac occlusive disease: factors influencing survival and function following reconstructive operation over a twenty-five-year period

Surgery. 1981 Dec;90(6):1055-67.


During a period of slightly over 25 years, 949 new patients with aortoiliac atherosclerotic occlusive disease--409 (43%) with associated distal disease--were submitted to various reconstructive operations for claudication in 719 and rest ischemic problems in 230 patients. The ages ranged from 21 to 91 years with a medial age of 59. Men outnumbered women 2.5 to 1. Associated diseases were present in 695 (75%); heart disease and diabetes were most common. The mortality rate from operation--50% of which was from heart disease--8% in first 5 years and 3% during the last 15 years. Good function, i.e., restoration of femoral pulses, leg salvage, and relief of symptoms, was achieved in 95% of cases early after treatment. Early results were best in patients with claudication and those without associated distal disease. The long-term survival rates were significant--50%, 30%, and 15% at 10, 15, and 20 years, respectively--and successful function was maintained in survivors in 79%, 70%, and 56% at the same intervals. Amputation was performed in only 23 (3%) patients with claudication and 33 (14%) with rest ischemia during the period of study. Survival, functional results, and incidence of amputation varied with the numerous factors described in detail herein.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amputation, Surgical
  • Aortic Diseases / surgery*
  • Arteriosclerosis / mortality
  • Arteriosclerosis / physiopathology
  • Arteriosclerosis / surgery*
  • Blood Vessel Prosthesis
  • Endarterectomy
  • Female
  • Follow-Up Studies
  • Humans
  • Iliac Artery / surgery*
  • Intermittent Claudication / surgery
  • Leg / blood supply
  • Male
  • Middle Aged
  • Pulse
  • Time Factors