title: Infragenicular in situ vein bypass graft occlusion: a multivariate risk factor analysis.
abstract: Early postoperative thrombosis and the later development of graft stenoses are the two major causes of vein bypass graft failure. The risk factors for both these outcomes were analysed in a multivariate analysis of 82 consecutive infragenicular in situ vein grafts. Twenty-four grafts failed within 30 days but eight were successfully revised. Technical errors accounted for six of the failures. A multivariate analysis revealed graft resistance > 1.4 peripheral resistance units (odds ratio 5.8, 95% C.I. 1.6-20) as the only independent risk factor for early graft failure. Eighteen grafts (27%) developed a stenosis most commonly in the distal third of the graft (46%). Poor quality, small diameter vein was the only independent risk factor for graft stenosis (odds ratio 7, 95% C.I. 1.5-34). Composite vein grafts, where narrowed and thickened vein had been replaced, had a significantly lower stenosis rate (difference in proportions 0.41, 95% C.I. 0.1-0.8, Mann-Whitney U test).
authors.affiliation: Department of Surgery, University of Leicester, Leicester Royal Infirmary, U.K.
authors.forename: K
authors.initials: K
authors.lastname: Varty
authors.forename: N J
authors.initials: NJ
authors.lastname: London
authors.forename: J A
authors.initials: JA
authors.lastname: Brennan
authors.forename: D A
authors.initials: DA
authors.lastname: Ratliff
authors.forename: P R
authors.initials: PR
authors.lastname: Bell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000473:pathology / Q000503:physiopathology; D006084:Graft Rejection; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D014655:Vascular Resistance; D014680:Veins / Q000637:transplantation*