Effect Of Inflow Vessel On Short-term Infection And Complication Rates During Infrainguinal Bypass
Tigran Divanyan, MD, Nicholas Russo, Neil Patel, B.S., Misak Harutyunyan, B.S., Ralph Clement Darling, III, Jeffrey Hnath, M.D..
Albany Med, Albany, NY, USA.
Objectives:In patients undergoing infrainguinal bypass, there are a variety of options to consider for bypass inflow based on patient history, presentation, and anatomy. Recent differences in infection rate and return to operating room based on inflow vessel has not yet been elucidated. The purpose of this study was to evaluate and compare outcomes in patient’s undergoing infrainguinal bypass based on their inflow vessel. Methods:The VQI database was queried for all patients who received an infrainguinal bypass between 1/1/2019 and 12/31/2020. These patients were divided into three groups based on inflow: common femoral artery (CFA), superficial femoral artery (SFA), and profunda femoris artery (PFA). Demographics and long-term results were recorded and compared. Groups were compared utilizing standard statistical analysis and chi squared analysis.Results: Between 2019 and 2020, there were 12,332 infrainguinal bypasses performed nationally (9404 CFA, 2438 SFA, 490 PFA). Patient gender and rates of coronary artery disease, hypertension, diabetes, end stage renal disease, and tobacco use was similar between all three cohorts (p>0.1). Use of vein or prosthetic varied between the three groups as well (CFA (48%v/52%p), SFA (77%v/23%p), PFA (623%v/37%p)). There was no significant difference observed between rates of outflow vessel choice (p>0.1). Regarding rates of wound infection, we cannot exclude an effect of inflow vessel on short term infection rate (2.6% (CFA), 2.6% (SFA), 3.1% (PFA)) (p=0.017). There was also a significant difference observed in the percentage of patients returning to the operating room for graft revision between the three cohorts (2.1% (CFA), 2.5% (SFA), 3.7% (PFA)) (p=0.034). Conclusion: It is important to consider implications of inflow vessel choice in patients undergoing infrainguinal bypass. Choosing between the common femoral, superficial femoral, or profunda femoris arteries may have a significant impact on patient outcomes including graft infection rates and return to the operating room.
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