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

Background: The most important factors that determine the outcome after fem oropopliteal and femorodistal arterial reconstruction are still controversi al. This report analysis the factors that determine the early and late pate ncy of distal arterial reconstruction. Patients and methods: A retrospective analysis of patency after femorodista l 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 haz ards 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 com posite and 43% for prosthetic reconstructions, respectively, at 12 months a fter arterial reconstruction. The cumulative life table patency rate in ext remities with good, intermediate and poor runoff was 62, 30 and 10%, respec tively, at 36 months. The patency rates for extremities operated on for cla udication was significantly better than for extremities operated on for cri tical ischaemia. The multivariate analysis of different factors in a Cox an alysis revealed that only the status of distal runoff the graft material an d the sire of the distal anastomosis independently and significantly influe nced the patency, rates. Conclusions: A new model for evaluation of distal runoff proved to predict the patency rate of femoropopliteal and femorodistal arterial reconstructio ns reasonably well in this retrospective analysis.