The Turkish Journal of Vascular Surgery

Yazarlar: Doğan Kahraman, Uğur Şener

Konular:-

Anahtar Kelimeler:Arterial bypass; endovascular procedures; infrainguinal bypass; peripheral vascular disease

Özet: Objectives: This study aims to investigate the effect of peripheral vascular interventions (PVIs) on future infrainguinal bypass (IIB). Patients and methods: Between January 2008 and January 2018, a total of 152 patients (110 males, 42 females; mean age 60.1±8.7 years; range, 38 to 81 years) who underwent lower extremity bypass surgery in our clinic with complete pre- and postoperative follow-up data were retrospectively analyzed using the hospital records. A successful percutaneous intervention was defined as the symptomatic improvement for one month after the procedure and these patients included in the study group (PVI group, n=53). Control group included patients who underwent open bypass without any prior endovascular intervention (IIB group, n=98). Pre-, intra-, and postoperative data were recorded. Results: Although critical leg ischemia was more common in the PVI group (p=0.03), the difference was not statistically significant compared to the preoperative data. The below-knee bypass was performed more frequently in the PVI group (41.5% vs. 19.2%, p<0.01). During the follow-up period, the rate of restenosis of the bypass graft was similar between the two groups, although the rate of minor amputations was significantly higher in the PVI group (p=0.04). There was a 1.6-fold increase in the relative risk of restenosis with previous PVI. Conclusion: Our study results suggest that PVIs result in a decrease in lower limb vascular reserve, particularly at the distal arteriolar level. In our study, the presence of more critical leg ischemia and high minor amputation rate in the PVI group support this proposal. In addition, reduced vascular reserve has the potential to adversely affect the future bypass.

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