Factors affecting the patency of infrainguinal bypass

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Presentation transcript:

Factors affecting the patency of infrainguinal bypass Robert B. Rutherford, MD, Darrell N. Jones, PhD, Sven-Erik Bergentz, MD, David Bergqvist, MD, Anthony J. Comerota, MD, Herbert Dardik, MD, William H. Flinn, MD, William J. Fry, MD, Kenneth McIntyre, MD, Wesley S. Moore, MD, Dhiraj M. Shah, MD, Takashi Yano, MD Journal of Vascular Surgery Volume 8, Issue 3, Pages 236-246 (September 1988) DOI: 10.1016/0741-5214(88)90273-X Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Comparison of the overall primary patency rates for each of the four graft types: RS, reversed saphenous; IS, in situ; PTFE, polytetrafluoroethylene; UV, modified human umbilical vein. All curves are different from one another with p < 0.01 or less. Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Primary patency rates for autogenous vein grafts (IS + RS = 78% at 3 years) are significantly better than for nonautogenous grafts (PTFE + UV = 31%) when the distal anastomosis was to the below-knee popliteal artery (p < 0.001). Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Primary patency rates for autogenous vein grafts (IS + RS = 78% at 3 years) are significantly better than for nonautogenous grafts (PTFE + UV = 10%) when the distal anastomosis was to the peroneal or tibial arteries (p < 0.001). This difference is greater than observed at the below-knee popliteal level (see Fig. 2). Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 For femorotibial bypass, the in situ graft (IS = 88%) gave significantly better patency than reversed saphenous vein (RS = 63%) (p < 0.05 at 36 months). Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Comparison of the cumulative hazard rates for risk of failure for each of the four grafts studied. Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Tobacco use had a significant deleterious effect on overall graft patency (p < 0.05). Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Diabetic patients enjoyed a significantly better overall primary patency rate than nondiabetics (p < 0.02) for reasons detailed in the text and in Tables III and IV. Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 8 The protective effect of dextran 40 infusions on graft patency waned during the 3-year follow-up. It appears to be sustained at 32 months in PTFE and UV grafts, but by this time statistical significance is lost (log rank test). Journal of Vascular Surgery 1988 8, 236-246DOI: (10.1016/0741-5214(88)90273-X) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions