Factors associated with long-term graft patency after lower extremity arterial bypasses

Purpose: This study was conducted to determine factors associated with long-term graft patency after lower extremity arterial bypass (LEAB). Methods: Database of LEABs for patients with chronic arterial occlusive disease (CAOD) at a single institution was retrospectively reviewed. To determine the factors we compared demographic, clinical, and procedural variables between 2 patient groups; group I (graft patency < 2 years) and group II (graft patency >= 5 years after LEAB) using univariable and multivariable analyses. Results: Among 957 LEABs, 259 limbs (group I, 125 limbs and group II, 134 limbs) in 213 patients were included for the analysis. On a univariable analysis, younger age (69 years vs. 66 years, P = 0.024), hypertension (60.8% vs. 74.6%, P = 0.017), claudication (51.2% vs. 70.9%, P = 0.001), absence of prior intervention (50.4% vs. 73.9%, P < 0.001), common femoral artery based bypass (57.6% vs. 70.1%, P = 0.035), above-the knee bypass (36.8% vs. 64.2%, P < 0.001), postoperative graft salvage procedure (3.2% vs. 14.8%, P = 0.001), and statin use (75.2% vs. 88.8, P = 0.004) were associated with long-term patency. On a multivariate analysis hypertension (odds ratio [OR], 1.91; P = 0.038), claudication (OR, 2.08; P = 0.032), no prior intervention (OR, 2.48; P = 0.001), vein graft (OR, 4.36; P = 0.001), above-the knee bypass (OR, 4.68; P < 0.001), and graft salvage procedures (OR, 7.70; P < 0.001) were identified as independent factors. Conclusion: These factors can be considered in decision making before treatment of patients with CAOD. [Ann Surg Treat Res 2021;100(3):175-185]

Automated summary

This study aimed to determine factors associated with long-term graft patency after lower extremity arterial bypass (LEAB) by retrospectively reviewing a database of LEABs for patients with chronic arterial occlusive disease (CAOD) at a single institution. The findings suggest that hypertension, claudication, no prior intervention, vein graft, above-the knee bypass, and graft salvage procedures are independent factors influencing long-term patency after LEAB. These factors may be considered in decision making before treating patients with CAOD.