OBJECTIVE

To identify risk factors of autovenous femoral-popliteal bypass occlusion in patients with atherosclerotic lesions of the lower limb arteries.

MATERIAL AND METHODS

Surgical treatment of 648 patients was retrospectively analyzed. Patients were divided into 2 clinical groups depending on postoperaitve outcomes: 290 (44.7%) patients with occlusion of autovenous conduit made up the first group; 358 (55.3%) patients without this complication were included in the second group. Mean period of patency of autovenous femoropopliteal bypass was 78±18 months. To determine risk factors of occlusion, we analyzed 104 variables (54 quantitative and 50 qualitative ones).

RESULTS

Increased body mass index and obesity were the risk factors of autovenous femoropopliteal graft occlusion. In the first group, obesity was found in 40.3% of cases (117 patients), in the second group — 24.9% (89 patients, p=0.048). There was a correlation between platelet level, reduced hematocrit and increased plateletcrit, increased blood glucose, C-reactive protein, creatinine, total cholesterol, as well as high coefficient of atherogenicity and occlusion of autovenous femoropopliteal bypass. The relationship between arterial hypertension grade 3 stage 3, myocardial infarction, chronic heart failure class 3 and diabetes mellitus with autovenous femoropopliteal bypass occlusion was noted. The level of proximal and distal anastomoses, autovenous conduit harvesting technique and method of its passage significantly affect patency of autovenous femoropopliteal bypass in long-term period.

CONCLUSION

Changes in metabolic status, lipid spectrum disorders, comorbidities, multifocal nature of atherosclerotic process, multiple-level lesions of lower limb arteries and features of surgical technique affect patency of autovenous femoropopliteal bypass graft in long-term period.