Sex-based outcomes of lower extremity bypass surgery in hemodialysis patients

Arhuidese, Isibor; Kernodle, Amber; Nejim, Besma; Locham, Satinderjit; Hicks, Caitlin W.; Malas, Mahmoud B.

doi:10.1016/j.jvs.2017.10.063

Cited by 15 publications

(3 citation statements)

References 27 publications

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“…Among those who received a prosthetic graft, acute graft failure was higher for females (HR, 1.23 [95% CI, 1.03–1.46]). 76…”

Section: Kidney Diseasementioning

confidence: 99%

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Martin,

Aday,

Almarzooq

et al. 2024

Circulation

223

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BACKGROUND: The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year’s worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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“…Among those who received a prosthetic graft, acute graft failure was higher for females (HR, 1.23 [95% CI, 1.03–1.46]). 76…”

Section: Kidney Diseasementioning

confidence: 99%

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Martin,

Aday,

Almarzooq

et al. 2024

Circulation

223

View full text Add to dashboard Cite

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“…Regarding the overall risk factors for patency loss, we found that bypasses involving limbs with critical limb ischemia, tibial distal targets use of prosthetic grafts and female gender were associated with higher rates of graft failure, which is similar to the existing literature. [13][14][15] We also found that obesity and advanced age were independently associated with less risk of patency loss, factors are not typically associated with graft protection. Focused studies on the effect of age and body habitus are thus avenues for future research within the VQI.…”

Section: Discussionmentioning

confidence: 83%

Comparison of mid-term graft patency in common femoral versus superficial femoral artery inflow for infra-geniculate bypass in the vascular quality initiative

Tran

Itoga

et al. 2020

Vascular

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Objectives The superficial femoral artery can be used as inflow for infra-geniculate bypass, but progressive proximal occlusive disease may affect graft durability. We sought to evaluate the effect of superficial femoral artery versus common femoral artery inflow on infra-geniculate bypass patency within a large contemporary multicenter registry. Methods The vascular quality initiative was queried from 2013 to 2019 to identify patients with >30-day patency follow-up, Rutherford chronic limb ischemia stage 1–6, and an infra-geniculate bypass, excluding those with prior ipsilateral bypass. The cohort was stratified by inflow vessel, with primary, primary-assisted, and secondary patency serving as the primary outcome variables. Multivariate Cox-proportional hazard models and radius-based propensity-score matching were performed to reduce treatment-selection bias due to clinical covariates. Results A total of 11,190 bypass procedures were performed (8378 common femoral artery inflow, 2812 superficial femoral artery) on 10,110 patients, with a mean follow-up of 12.8 months (range 1–98). Patients receiving superficial femoral artery inflow bypasses were more commonly male ( p = 0.002), obese ( p < 0.0001) and had chronic, limb threatening ischemia ( p < 0.0001), whereas those with common femoral artery inflow were older ( p < 0.0004), and had higher baseline comorbidities including smoking ( p < 0.0001), coronary disease ( p < 0.0001), and pulmonary disease ( p < 0.0001). On life-table analysis, there was no significant difference in three year estimated primary (32.1 vs 30.1%, p = 0.928), primary assisted (60.5 vs 65.8%, p = 0.191), or secondary patency (62.5 vs 66.7%, p = 0.139) between superficial femoral artery and common femoral artery inflow groups, respectively. A multivariate Cox model found no significant association between inflow vessel and primary patency (0.96 [0.88–1.04], HR [95%CI]), primary-assisted (1.07 [0.95–1.20], HR [95%CI]), or secondary patency (1.08 [0.96–1.22]). In a propensity-matched cohort ( n = 11,151), there were small but statistically significant differences in primary, primary-assisted, and secondary patency at latest follow-up (non-time-to-event data) between groups. The largest difference was observed when evaluating secondary patency, with common femoral artery inflow having a marginally higher secondary patency of 88.1% compared to 85.6% for those with superficial femoral artery inflow at latest follow-up ( p = 0.009). Conclusions Within the vascular quality initiative, there is no significant difference in life-table determined three-year primary, primary-assisted, and secondary patency between infra-geniculate bypasses using common femoral artery inflow compared to superficial femoral artery inflow. Small, statistically significant differences exist in primary, primary-assisted, and secondary patency favoring common femoral artery inflow after propensity score matching. Long-term follow-up data are required in the vascular quality initiative to better evaluate bypass graft durability as this study was limited by a mean follow-up of one year.

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“…19 In contrast to HD-dependent patients, there were no significant differences in the risk-adjusted outcomes between male and female patients; however, the lower patency and limb salvage noted in black HD patients relative to whites persisted in this study. 28,29 This study is limited in its retrospective design and use of an administrative database. However, data from the USRDS are prospectively collected, are validated, and have been used for peer-reviewed vascular surgery studies in the past.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 99%

Outcomes of lower extremity bypass surgery in patients with renal transplants

Arhuidese

Nejim

Craig‐Schapiro

et al. 2018

Journal of Vascular Surgery

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Objective: Outcomes of infrainguinal bypass surgery (IBS) in patients with renal transplants are largely undescribed. This study evaluated perioperative and long-term outcomes of IBS using autogenous and prosthetic conduits in a large population-based cohort of renal transplantation patients.Methods: A retrospective review of all renal transplantation patients who underwent IBS between January 2007 and December 2011 in the United States Renal Data System was performed. Univariable, Kaplan-Meier, multivariable logistic, and Cox regression analyses were employed to evaluate 30-day postoperative (graft failure, limb loss, conduit infection, and death) and long-term (primary patency, primary assisted patency, secondary patency, limb salvage, and mortality) outcomes.Results: There were 1048 IBSs performed (autogenous, 68%; prosthetic, 32%), predominantly for critical limb ischemia (70%). Of these, 480 (46%) were femoral-popliteal, 330 (31%) were femoral-tibial, and 238 (23%) were popliteal-tibial bypasses. Comparing autogenous vs prosthetic conduits, primary patency was 33% vs 28% (P ¼ .22), primary assisted patency was 38% vs 31% (P ¼ .13), secondary patency was 48% vs 53% (P ¼ .67), limb salvage was 53% vs 63% (P ¼ .73), and patient survival was 47% vs 51% (P ¼ .88), all at 5 years. Risk-adjusted analyses demonstrated higher primary assisted patency (adjusted hazard ratio [aHR], 1.33; 95% confidence interval [CI], 1.06-1.66; P ¼ .012), secondary patency (aHR, 1.33; 95% CI, 1.02-1.74; P ¼ .034), and limb salvage (aHR, 1.35; 95% CI, 1.02-1.80; P ¼ .037) for autogenous compared with prosthetic bypasses. There was no difference in mortality of patients who received autogenous vs prosthetic conduits. Conclusions:We have presented postoperative and long-term outcomes of IBS in renal transplantation patients. Autogenous bypasses outperform prosthetics with regard to primary assisted patency, secondary patency, and limb salvage. Given the modest survival advantage conferred by renal transplantation, maximum efforts should be made to create bypasses with autogenous conduits when it is feasible. These results should inform the patient's and surgeon's expectations in planning of IBS for these patients.

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Sex-based outcomes of lower extremity bypass surgery in hemodialysis patients

Cited by 15 publications

References 27 publications

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Comparison of mid-term graft patency in common femoral versus superficial femoral artery inflow for infra-geniculate bypass in the vascular quality initiative

Outcomes of lower extremity bypass surgery in patients with renal transplants

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