1. Comparison of mid-term graft patency in common femoral versus superficial femoral artery inflow for infra-geniculate bypass in the vascular quality initiative
- Author
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Jordan R. Stern, Kenneth Tran, Vy T. Ho, and Nathan K. Itoga
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Occlusive disease ,Inflow ,030204 cardiovascular system & hematology ,030230 surgery ,Risk Assessment ,Article ,Blood Vessel Prosthesis Implantation ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Ischemia ,Risk Factors ,Geniculate ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Registries ,Vascular Patency ,Aged ,Graft patency ,Superficial femoral artery ,business.industry ,Graft Occlusion, Vascular ,General Medicine ,Intermittent Claudication ,Middle Aged ,United States ,Blood Vessel Prosthesis ,Surgery ,Femoral Artery ,Treatment Outcome ,Chronic Disease ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives The superficial femoral artery can be used as inflow for infra-geniculate bypass, but progressive proximal occlusive disease may affect graft durability. We sought to evaluate the effect of superficial femoral artery versus common femoral artery inflow on infra-geniculate bypass patency within a large contemporary multicenter registry. Methods The vascular quality initiative was queried from 2013 to 2019 to identify patients with >30-day patency follow-up, Rutherford chronic limb ischemia stage 1–6, and an infra-geniculate bypass, excluding those with prior ipsilateral bypass. The cohort was stratified by inflow vessel, with primary, primary-assisted, and secondary patency serving as the primary outcome variables. Multivariate Cox-proportional hazard models and radius-based propensity-score matching were performed to reduce treatment-selection bias due to clinical covariates. Results A total of 11,190 bypass procedures were performed (8378 common femoral artery inflow, 2812 superficial femoral artery) on 10,110 patients, with a mean follow-up of 12.8 months (range 1–98). Patients receiving superficial femoral artery inflow bypasses were more commonly male ( p = 0.002), obese ( p Conclusions Within the vascular quality initiative, there is no significant difference in life-table determined three-year primary, primary-assisted, and secondary patency between infra-geniculate bypasses using common femoral artery inflow compared to superficial femoral artery inflow. Small, statistically significant differences exist in primary, primary-assisted, and secondary patency favoring common femoral artery inflow after propensity score matching. Long-term follow-up data are required in the vascular quality initiative to better evaluate bypass graft durability as this study was limited by a mean follow-up of one year.
- Published
- 2020
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