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

Abstract

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.

The Effect of Statins on the Patency Rate of Peripheral Vessels after Balloon Angioplasty

“…The non-statin group, on the other hand, included more patients with CLI (77 percent vs 57 percent, p<0.001), non-ambulatory status (25. Jung et al, [13] reported that when the patient characteristics of the two groups were examined, group II patients were younger (median, 69 years vs. 66 years; p=0.024) and more hypertensive (60.8 percent vs. 74.6 percent; p=0.017) than group I patients (short-term graft patency). There were more limbs in Group II with claudication as a reason for LEAB (51.2 percent vs. 70.9 percent, p=0.001), but no substantial variations in other comorbidities or blood test findings.…”

Statins and Peripheral Arterial Disease: A Narrative Review

“…In one study, the use of statins was associated with better lesion permeability in patients undergoing infrapopliteal angioplasty and greater amputation-free survival, but did not decrease the rate of amputations ( 123 ). Another very recent study in patients with bypass observed that statin therapy was associated with long-term graft permeability on the univariate analysis, but was no longer an independent factor on the multivariate analysis ( 106 ).…”