Morbidity and mortality after aortofemoral grafting for peripheral limb ischaemia.

Over a 10-year period, aortofemoral grafting was employed in the revascularization of 484 limbs in 245 patients with peripheral limb ischaemia. Six patients (2.4%) died in the postoperative period, the most common cause of death being myocardial infarction. Forty-three patients (18%) developed significant non-fatal complications within 30 days of operation, half of whom required further surgery as a consequence. Thirty-seven patients suffered late graft-related complications of which graft thrombosis was the most common. Immediate graft patency was 98.4%, cumulative patency was 95% and 87% at 1 and 5 years respectively. False aneurysm formation was encountered in 3.3% of patients, deep graft sepsis in 1.6% and the phenomenon of 'non-healing' of grafts in 1.2%. Cumulative survival following elective surgery was 97% and 84% at 1 and 5 years respectively, and 89% and 72% for those undergoing limb salvage procedures.