Inferior outcomes of autogenous infrainguinal bypass in Hispanics: An analysis of ethnicity, graft function, and limb salvage

Robinson, William P.; Owens, Christopher D.; Nguyen, Louis L.; Chong, Tze Tec; Conte, Michael S.; Belkin, Michael

doi:10.1016/j.jvs.2009.02.010

Cited by 40 publications

(43 citation statements)

References 39 publications

(45 reference statements)

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“…The present study confirms the earlier findings that minority ethnicity in hemodialysis patients confers significantly improved survival over that seen in white hemodialysis patients. 7,8,22,23 Previous reports have also noted that, in particular, Hispanic hemodialysis patients have a survival advantage over nonHispanic hemodialysis patients. 24…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Influence of Vascular Access Type on Sex and Ethnicity-Related Mortality in Hemodialysis-Dependent Patients

Woo¹,

Yao²,

Selevan³

et al. 2012

TPJ

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Section: Discussionmentioning

confidence: 97%

“…[19][20][21][22] These associations are not well defined in the area of dialysis access surgery. Thus, the purpose of this study was to examine the relationships between mortality, vascular access type, sex, and ethnicity in a large health maintenance organization's dialysis population.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Influence of Vascular Access Type on Sex and Ethnicity-Related Mortality in Hemodialysis-Dependent Patients

Woo¹,

Yao²,

Selevan³

et al. 2012

TPJ

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“…50 In a post hoc analysis of the PREVENT III (Project of Ex Vivo Vein Graft Engineering via Transfection III) trial, a multicenter trial that evaluated the results of vein bypass surgery for chronic critical limb ischemia, the impact of gender and ethnicity was evaluated. 42 This study cohort included 249 45 In summary, gender, race, and ethnicity appear to be synergistic determinants of vein graft failure and limb loss.…”

Section: Ethnic and Social Distribution Of Clinical Presentation In Wmentioning

confidence: 99%

A Call to Action: Women and Peripheral Artery Disease

Hirsch

Allison²,

Gomes³

et al. 2012

Circulation

281

138

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“…Traditional study end points for these patients have included graft patency, 1,2 limb salvage, 3,4 or death. 5,6 More recently, however, alternative end points have emerged that include amputation-free survival, 7–9 major adverse cardiovascular events, 9 target limb revascularization, 10 quality of life, 11 and functional outcomes such as the ability to ambulate or to live independently after surgery.…”

mentioning

confidence: 99%

Failure to achieve clinical improvement despite graft patency in patients undergoing infrainguinal lower extremity bypass for critical limb ischemia

Simons

Goodney

Nolan

et al. 2010

Journal of Vascular Surgery

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Objective Studies of infrainguinal lower extremity bypass for critical limb ischemia (CLI) have traditionally emphasized outcomes of patency, limb salvage, and death. Because functional outcomes are equally important, our objectives were to describe the proportion of CLI patients who did not achieve symptomatic improvement 1 year after bypass, despite having patent grafts, and identify preoperative factors associated with this outcome. Methods The prospectively collected Vascular Study Group of Northern New England database was used to identify all patients with elective infrainguinal lower extremity bypass for CLI (2003 to 2007) for whom long-term follow-up data were available. The primary composite study end point was clinical failure at 1 year after bypass, defined as amputation or persistent or worsened ischemic symptoms (rest pain or tissue loss), despite a patent graft. Variables identified on univariate screening (inclusion threshold, P < .20) were included in a multivariable logistic regression model to identify independent predictors. Results Long-term follow-up data were available for 1012 patients who underwent infrainguinal bypasses for CLI, of which 788 (78%) remained patent at 1 year. Of these, 79 (10%) met criteria for the composite end point of clinical failure: 21 (2.7%) for major amputations and 58 (7.4%) for persistent rest pain or tissue loss. In multivariable analysis, significant predictors of clinical failure included dialysis dependence (odds ratio [OR], 3.74; 95% confidence interval [CI], 1.84–7.62; P < .001) and preoperative inability to ambulate independently (OR, 2.17; 95% CI, 1.26–3.73; P = .005). A history of coronary artery bypass graft or percutaneous coronary intervention was protective (OR, 0.52; 95% CI, 0.29–0.93; P = .03). Conclusions After infrainguinal lower extremity bypass for CLI, 10% of patients with a patent graft did not achieve clinical improvement at 1 year. Preoperative identification of this specific patient subgroup remains challenging. To improve surgical decision making and the overall care of CLI patients, further emphasis needs to be placed on functional outcomes in addition to traditional surgical end points.

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Inferior outcomes of autogenous infrainguinal bypass in Hispanics: An analysis of ethnicity, graft function, and limb salvage

Cited by 40 publications

References 39 publications

Influence of Vascular Access Type on Sex and Ethnicity-Related Mortality in Hemodialysis-Dependent Patients

Influence of Vascular Access Type on Sex and Ethnicity-Related Mortality in Hemodialysis-Dependent Patients

A Call to Action: Women and Peripheral Artery Disease

Failure to achieve clinical improvement despite graft patency in patients undergoing infrainguinal lower extremity bypass for critical limb ischemia

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