title: The prostacyclin analogue beraprost sodium prevents occlusion of bypass grafts in patients with lower extremity arterial occlusive disease: a 20-year retrospective study.
abstract: Although conventional bypass grafting is commonly used to treat ischemia in lower extremities, graft failure often occurs. This study retrospectively analyzed the factors that affect graft patency to help establish more effective treatment of obstructive arterial disease of the lower limbs. Kaplan-Meier analysis was used to estimate graft patency in 90 legs of 80 patients who underwent femoropopliteal bypass (28 vein grafts and 62 expanded polytetrafluoroethylene grafts) between 1984 and 2003. Patients were randomly selected for graft materials in sequential surgical treatment order. After initial analysis, several risk factors and postoperative medication regimens were analyzed to ascertain any association with graft failure. The overall mean patency period for femoropopliteal bypass was 10.5 +/- 0.7 years. Graft occlusion occurred in 20 limbs. Neither the materials composing the grafts nor the position of distal anastmosis had any influence on patency maintenance. Graft occlusion rates were significantly greater in patients with either diabetes (p = 0.0049) or rest pain before surgery (p = 0.0011). Postoperative administration of beraprost sodium significantly increased the patency period (p = 0.0082). Diabetes and rest pain before surgery are important factors for late graft failure after femoropopliteal bypass. Our data also suggest that administration of beraprost sodium increases the graft patency period.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Metropolitan Hiroo General Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo, Japan.
authors.forename: Mikiko
authors.initials: M
authors.lastname: Murakami
authors.forename: Masazumi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakahara
mesh_terms: D000368:Aged; D001162:Arteriosclerosis Obliterans / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D003925:Diabetic Angiopathies / Q000601:surgery; D011464:Epoprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011150:Popliteal Artery / Q000601:surgery; D011184:Postoperative Period; D012189:Retrospective Studies; D014654:Vascular Patency
chemical_list: D010975:Platelet Aggregation Inhibitors; C048081:beraprost; D011464:Epoprostenol