Long-term patency of the aortofemoral Dacron graft. A graft limb related study over a 25-years period.

Graft limb patency was studied retrospectively in a consecutive series of 912 patients (1605 limbs), who received an aorto(bi)femoral Dacron graft for occlusive disease over a 25 years period (1963-1987). The mean follow-up for the series was 5.35 years (range 1 month to 23 years) and 18.5% of the patients were followed for at least 10 years. Primary patency decreased progressively to 83% at 10 years and 77% at 15 years. It was significantly improved to 90% (at 10 years) and 84% (at 15 years) by means of operative thrombectomy (secondary patency). Factors influencing patency (univariate analysis) were (1) concomitant femoropopliteal occlusive disease, (2) the site of the femoral anastomosis and (3) the date of the operation. Multivariate analysis in relation to the femoral anastomosis stressed the importance of profunda femoris artery disease and the date of operation. It is concluded that the negative effects of concomitant superficial femoral artery disease may be completely relieved by an adequate profundaplasty. Furthermore the substantial progress, we documented over the years of the study, supports our view that aortofemoral reconstruction may also be offered as the solution of choice to patients with milder forms of claudication.