PHARMACOLOGICAL PROPHYLAXIS AGAINST POSTOPERATIVE GRAFT OCCLUSION AFTER PERIPHERAL VASCULAR-SURGERY - A WORLDWIDE SURVEY

Objectives: To define current practice regarding the use of pharmacolo gical prophylaxis to prevent postoperative graft occlusion. Design: Pr ospective open questionnaire. Materials and Methods: Questionnaires re garding this subject were sent to vascular surgeons throughout the wor ld to analyse current practice. Results: 651 questionnaires were retur ned with a response rate of 62% and form the basis for this report. Da ta from 100334 vascular reconstructions were reported in this survey. Prophylaxis against postoperative graft occlusions was common. Treatme nt periods were usually greater than 1 year. Among carotid surgery pat ients, 82% received prophylaxis, consisting mainly of low-dose acetysa licylic acid (ASA). In Mid-Europe the use of oral anticoagulation was more common than in other regions (p < 0.001). Among aneurysm surgery patients, 38% received prophylaxis. For infrainguinal bypass, ASA in l ow dose was the most commonly used agent worldwide. However, oral anti coagulation was mole frequent in Mid-Europe, in contrast to South Amer ica where the combination of ASA and dipyridamole was most common. Con siderable geographical differences regarding patient selection, the fr equency of specific procedures and operative techniques existed. Concl usions: Important world-wide differences exist regarding prophylaxis f or postoperative graft occlusion.