Factors Associated with Infrainguinal Bypass Graft Patency at 1-year; a Retrospective Analysis of a Single Centre Experience

Overview

Journal Perfusion

Publisher Sage Publications

Date 2021 Feb 27

PMID 33637022

Authors

Pasha Normahani

Ismail Yusuf Anwar

Alona Courtney

Amish Acharya

Viknesh Sounderajah

Chira Mustafa

Usman Jaffer

Affiliations

Soon will be listed here.

Abstract

Introduction: The aim of this study was to identify factors associated with primary graft patency 1 year following open lower limb revascularisation (LLR) at a tertiary referral vascular service.

Methods: A retrospective analysis of patients undergoing infra-inguinal bypass surgery between January 2016 and May 2017 at a tertiary vascular centre (St Mary's Hospital, London) was performed. Data regarding patient demographics, comorbidities, type of operation and post-operative anti-thrombotic strategy were collected. Quality of run-off score was assessed from pre-operative imaging.

Results: Seventy-seven cases were included in the analysis. Overall, the primary patency rate at 1-year was 63.6% ( = 49/77) and the secondary patency rate was 67.5% ( = 52/77). Independent variables with statistically significant inferior patency rates at 1-year were (1) bypasses with below knee targets (p = 0.0096), (2) chronic limb threatening ischaemia indication (p = 0.038), (3) previous ipsilateral revascularisation (p < 0.001) and (4) absence of hypertension history (p = 0.041). There was also a trend towards significance for American Society of Anesthesiologists (ASA) grade (p = 0.06). Independent variables with log-rank test p values of <0.1 were included in a Cox proportional hazards model. The only variable with a statistically significant impact on primary patency rates was previous open or endovascular ipsilateral revascularisation (HR 2.44 (1.04-5.7), p = 0.04).

Conclusion: At 1-year follow-up, previous ipsilateral revascularisation was the most significant factor in affecting patency rates. Patients in this subgroup should therefore be deemed high-risk, which should be reflected in the informed consent and peri-operative management.

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