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Frequency of repeated vascular surgery. A survey of 7616 surgical and endovascular Finnvasc procedures. Finnvasc Study Group.

OBJECTIVE
To assess the incidence of repeated vascular surgical operations.


DESIGN
A population-based cross-sectional survey established on the Finnvasc registry.


SETTING
Multicentre, Finland.


MATERIAL
7616 vascular procedures consisted of 5201 open vascular operations and 2415 endovascular interventions done during the two years 1991-92.


MAIN OUTCOME MEASURES
Mortality and number of reoperations and major amputations.


RESULTS
A total of 5409 initial vascular procedures were done, 770 patients (10%) underwent a new procedure in the same anatomical segment as previously, and 1437 patients (19%) underwent a vascular or endovascular procedure on a new arterial segment excluding the coronary arteries; these patients had more risk factors than the two other groups, and were also treated more often for chronic leg ischaemia. Altogether 586 reoperations were needed in 487 patients (6%) during a 30-day postoperative period, more often after the initial surgical reconstruction than on other occasions. Altogether 126 postoperative below-knee and 170 above-knee amputations had to be done during the same period which corresponded to 14% of the total of 2128 surgical or endovascular revascularisations done for acute or chronic critical leg ischaemia. The risk of perioperative death was higher in patients with acute leg ischaemia undergoing their first vascular intervention than those having repeat operations.


CONCLUSION
Although the present data are cross-sectional and might be affected by the recent increase in vascular surgery in Finland they show that almost a third of vascular operations done are repeat procedures.