Betz, Thomas and Toepel, Ingolf and Pfister, Karin and Lang, Malisia and Steinbauer, Markus and Uhl, Christian and Zeman, Florian and Schierling, Wilma (2022) Impact of chronic kidney disease on the outcomes of infrapopliteal venous, and heparin-bonded expanded polytetrafluoroethylene bypass surgeries: A retrospective cohort study. VASCULAR MEDICINE, 27 (1): 1358863X21. pp. 55-62. ISSN 1358-863X, 1477-0377
Full text not available from this repository. (Request a copy)Abstract
The aim of this study was to analyze the results of infrapopliteal venous and prosthetic bypass surgeries for patients with chronic limb-threatening ischemia (CLTI) and moderate to severe chronic kidney disease (CKD). All consecutive patients undergoing infrapopliteal bypass surgeries at two academic vascular centers between March 2002 and November 2018 were included in this retrospective study. During this timeframe, infrapopliteal grafts were performed for 487 patients. Of these patients, 160 (32.9%; group 1) had normal renal function, 248 (50.9%; group 2) had moderate CKD, and 79 (16.2%; group 3) had severe CKD according to the Kidney Disease Improving Global Outcomes guidelines. After 5 years' follow-up, the primary patency rate was 46.0% and the secondary patency rate was 54.9% without statistical significance noted between the CKD groups. Limb salvage (65.3%, p = 0.024) and long-term survival (19.6%, p < 0.001) were considerably lower in patients with severe CKD. In subgroup analysis, vein grafts had significantly better long-term patency rates compared to prosthetic grafts, regardless of CKD group. However, in patients with severe CKD, patency rates of vein and heparin-bonded expanded polytetrafluoroethylene (HePTFE) grafts were comparable at the 1-year mark. Our study shows that autologous vein grafts remain the first choice for infrapopliteal bypass surgeries in patients with CKD. HePTFE grafts showed good short-term results in patients with severe CKD. Given the short life expectancy of these high-risk patients, prosthetic HePTFE grafts may be reasonable in this population if a suitable vein is absent.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CRITICAL LIMB ISCHEMIA; PERIPHERAL ARTERY-DISEASE; VEIN; REVASCULARIZATION; FEMOROPOPLITEAL; MANAGEMENT; GRAFTS; RISK; chronic limb-threatening ischemia (CLTI); dialysis; heparin-bonded expanded polytetrafluoroethylene (HePTFE); peripheral artery disease (PAD); vascular surgery; chronic kidney disease (CKD) |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Gefäßchirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 Sep 2022 07:00 |
| Last Modified: | 05 Sep 2022 07:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46559 |
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