Author(s)

Paddy D Hallihan, Niamh Ni Choileain, Eddie Myers, H. P Redmond, Greg F Fulton

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Background and purpose Infrainguinal arterial reconstruction increases limb salvage rates, however, the fac- tors that predict time to graft failure remain ill-defined. The aim of this study was to define such predictors. Methods A retrospective analysis of infrainguinal arterial reconstructions performed for symptomatic pe- ripheral arterial disease refractory to medical/interventional therapies over a 6 year period was performed. Demographics and adverse outcomes were analysed and statistical significance was determined using Chi-squared analysis, the Student t test and the Wilcoxon signed-rank test. Main findings 170 procedures were analysed. The male to female ratio was 4:3. The median age was 70.1 years. The post-operative com- plication rate was 12%. On univariate analysis, female gender, the use of a synthetic graft, and the presence of critical ischaemia at the time of surgery were predictive of time to graft failure (ρ ≤ 0.05, ρ ≤ 0.03, ρ ≤ 0.02 respectively). On multivariate analysis, the 3 most significant predictors were the occurrence of a post-operative complication, female gender and a high ASA grade. The presence of diabetes mellitus and smoking did not adversely affect graft outcome, (ρ ≤ 0.23, ρ ≤ 0.20 respectively). Conclusion This study suggests that female gender adversely affects graft patency while a history of smoking and the presence of diabetes mellitus do not. Our findings also suggest that the occurrence of a post-operative complication, and a high ASA grade at time of surgery are additional important predictors of early and late graft failure.

Infrainguinal, Vascular Surgery, Bypass, Graft, Patency

P. Hallihan, N. Choileain, E. Myers, H. Redmond and G. Fulton, "Predictors of Time to Graft Failure Following Infrainguinal Arterial Reconstruction," Surgical Science, Vol. 2 No. 4, 2011, pp. 166-172. doi: 10.4236/ss.2011.24036.