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A multivariate analysis of factors affecting patency of femoropopliteal and femorodistal bypass grafting.

BACKGROUND
The most important factors that determine the outcome after femoropopliteal and femorodistal arterial reconstruction are still controversial. This report analysis the factors that determine the early and late patency of distal arterial reconstruction.


PATIENTS AND METHODS
A retrospective analysis of patency after femorodistal arterial reconstruction with a new method for evaluation of angiographic runoff was performed for 336 arterial reconstructions. The different pre-, per- and postoperative risk factors were analysed in a Cox proportional hazards model.


RESULT
The patency was significantly better for vein grafts in comparison to composite grafts and prosthetic grafts. It was 74% for vein, 46% for composite and 43% for prosthetic reconstructions, respectively, at 12 months after arterial reconstruction. The cumulative life table patency rate in extremities with good, intermediate and poor runoff was 62, 30 and 10%, respectively at 36 months. The patency rates for extremities operated on for claudication was significantly better than for extremities operated on for critical ischaemia. The multivariate analysis of different factors in a Cox analysis revealed that only the status of distal runoff, the graft material and the site of the distal anastomosis independently and significantly influenced the patency rates.


CONCLUSIONS
A new model for evaluation of distal runoff proved to predict the patency rate of femoropopliteal and femorodistal arterial reconstructions reasonably well in this retrospective analysis.