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 PS100. Prosthetic Graft vs. Vein as Conduit for Extra-anatomic Bypass: Short-term Outcomes from a National Database

​Bala Natarajan1, Prateek K. Gupta1, Thomas G. Lynch4, Jason Mactaggart4, Marcus Balters1, Himani Gupta2, Xiang Fang3, G. Matthew Longo4, Jason M. Johanning4, Iraklis I. Pipinos4
1Surgery, Creighton University, Omaha, NE; 2VA Nebraska and Western Iowa Health Care System, Omaha, NE; 3Creighton University-Department of Biostatistics, Omaha, NE; 4Departments of Surgery, University of Nebraska Medical Center, and VA Nebraska and Western Iowa Health Care System, Omaha, NE.

OBJECTIVES: To compare 30-day mortality and graft failure after use of prosthetic graft (PG) vs. vein graft (VG) as conduit for extra-anatomic arterial bypass (EAB).

METHODS: Patients who underwent axillary-femoral artery bypass (AFB) and femoral-femoral artery bypass (FFB) grafts were identified from the 2007-09 National Surgical Quality Improvement Program (NSQIP) database. Multivariable logistic regression analysis was performed to identify preoperative factors associated with 30-day mortality and graft failure.

RESULTS: Of the 493 patients who underwent AFB, 89 (18.05%) received a VG and 404 (81.95%) received a PG. Thirty-day mortality rates for patients receiving VG and PG were 2.25% and 6.19%, respectively (p=0.14) and graft failure rates were 6.74% and 2.97%, respectively (p=0.08). On multivariate analysis, there was no difference in 30-day mortality (odds ratio (OR)=0.53; 95% confidence interval (CI) =0.11-2.56) or graft failure rate (OR=2.38; 0.77-7.34) for patients receiving VG or PG for AFB.
Of the 1,219 patients who underwent FFB, 251(20.59%) received a VG and 968 (79.41%) received a PG. Thirty-day mortality rates for patients receiving VG and PG were 1.99% and 1.03%, respectively (p=0.21) and graft failure rates were 3.98% and 1.65%, respectively (p=0.04). On multivariate analysis, there was no difference in 30-day mortality (OR=1.45; CI=0.38-5.59) or graft failure rate (OR=2.19; CI=0.94-5.08) for patients receiving VG or PG for FFB.

CONCLUSIONS: Thirty-day mortality and graft failure rate are independent of the type of conduit used in patients undergoing extra-anatomic arterial bypass.

AUTHOR DISCLOSURES: M. Balters, Nothing to disclose; X. Fang, Nothing to disclose; H. Gupta, Nothing to disclose; P. K. Gupta, Nothing to disclose; J. M. Johanning, Nothing to disclose; G. Longo, Nothing to disclose; T. G. Lynch, Nothing to disclose; J. Mactaggart, Nothing to disclose; B. Natarajan, Nothing to disclose; I. I. Pipinos, Nothing to disclose.

Posted April 2012

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