Antiplatelet drugs in femoropopliteal vein bypasses: A multicenter trial Charles McCollum, MB, ChB, MD, FRCS, Christine Alexander, Dip N, Glenda Kenchington,

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Presentation transcript:

Antiplatelet drugs in femoropopliteal vein bypasses: A multicenter trial Charles McCollum, MB, ChB, MD, FRCS, Christine Alexander, Dip N, Glenda Kenchington, BSc, Peter J. Franks, PhD, Roger Greenhalgh, MA, MD, MCh, FRCS Journal of Vascular Surgery Volume 13, Issue 1, Pages 150-162 (January 1991) DOI: 10.1016/0741-5214(91)90022-M Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 The rate of graft failure expressed per 1000 patient-months at risk demonstrates that most grafts failed in the first 12 months with the peak failure rate in the first 3 months being 43/1000 patient-months, which fell to under 10/1000 in subsequent years. Journal of Vascular Surgery 1991 13, 150-162DOI: (10.1016/0741-5214(91)90022-M) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Graft patency was measured objectively and plotted by use of life-table methods comparing patients randomized to ASA + DPM and placebo. An apparent improvement in patency over the first 2 years with ASA + DPM is lost by 3 years, and the overall difference does not achieve statistical significance (p = 0.43). Journal of Vascular Surgery 1991 13, 150-162DOI: (10.1016/0741-5214(91)90022-M) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Analysis of the traditional risk factors for femoropopliteal graft patency by means of the life-table method failed to demonstrate an important influence of (A) distal anastamosis above or below the knee or (B) indication for arterial reconstruction. The severity of arterial disease at the distal anastamosis recorded by the operating surgeon (C) was significantly associated with subsequent graft performance (p = 0.038). The participating surgeons used reversed or in situ techniques for vein bypass according to their preference, and this choice had no effect on subsequent patency (D). Journal of Vascular Surgery 1991 13, 150-162DOI: (10.1016/0741-5214(91)90022-M) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Analysis of the traditional risk factors for femoropopliteal graft patency by means of the life-table method failed to demonstrate an important influence of (A) distal anastamosis above or below the knee or (B) indication for arterial reconstruction. The severity of arterial disease at the distal anastamosis recorded by the operating surgeon (C) was significantly associated with subsequent graft performance (p = 0.038). The participating surgeons used reversed or in situ techniques for vein bypass according to their preference, and this choice had no effect on subsequent patency (D). Journal of Vascular Surgery 1991 13, 150-162DOI: (10.1016/0741-5214(91)90022-M) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Overall mortality rate in these patients was high, and although reduced by 13% on ASA + DPM this difference has failed to achieve statistical significance (p = 0.14). Journal of Vascular Surgery 1991 13, 150-162DOI: (10.1016/0741-5214(91)90022-M) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions