Different methods of femoropopliteal bypass grafting with autologous vein: propensity score matching analysis

Zakeryaev AB, Vinogradov RA, Sukhoruchkin PV, et al. . Different methods of femoropopliteal bypass grafting with autologous vein: propensity score matching analysis. Pirogov Russian Journal of Surgery. 2022;(10):44‑50. (In Russ.)
https://doi.org/10.17116/hirurgia202210144

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze immediate and long-term results of various methods of femoropopliteal bypass grafting with autologous vein using propensity score matching.

MATERIAL AND METHODS

A retrospective single-center open study included 464 patients who underwent femoropopliteal bypass grafting with an autologous vein between January 10, 2016 and December 25, 2019 at the Research Institute — Ochapovsky Regional Clinical Hospital No. 1. The following types of autovenous conduits were used: n=266 — reversed autologous vein (group 1); n=59 — in situ autologous vein (group 2); n=73 — upper limb autologous vein (group 3); n=66 — ex situ autologous vein (group 4). The long-term period was 16.6±10.3 months.

RESULTS

We used propensity score matching analysis because patients were not comparable for some indicators. Groups 2-4 included small samples of patients, and their number was reduced to less than 10. This did not allow us to draw reliable conclusions about treatment outcomes. In this situation, we decided to allocate two groups: group 1 — ex situ femoropopliteal bypass grafting; group 2 — other variants of femoropopliteal bypass grafting with autologous vein. Propensity score matching allocated 299 people in group 1 and 46 patients in group 2. There were significant differences in early postoperative incidence of autologous vein thrombosis (group 1: n=3 (6.5%), group 2: n=79 (26.4%), p=0.003; OR= 0.19; 95% CI 0.05-0.64) and postoperative wound suppuration (group 1: n=2 (4.3%), group 2: n=52 (17.4%); p=0.02; OR=0.21; 95% CI 0.05-0.91). In long-term postoperative period, significant differences were obtained in the incidence of limb amputation (group 1: n=6 (13%), group 2: n=85 (28.4%); p=0.02; OR=0.37; 95% CI 0.15-0.92) and myocardial infarction (group 1: n=1 (2.2%), group 2: n=43 (14.4%); p=0.02; OR 0.13; 95% CI 0.01-0.98).

CONCLUSION

Femoropopliteal bypass grafting ex situ is characterized by lower incidence of graft thrombosis, amputations of the limb, mild decrease in the incidence of infectious complications and all adverse cardiovascular events in early and late postoperative period compared to conventional surgery (reversed autologous vein, in situ autologous vein, upper limb autologous vein).

Keywords:

femoropopliteal bypass

propensity score matching

reversed autologous vein

in situ autologous vein

ex situ autologous vein

upper limb autologous vein

graft thrombosis

amputation

Authors:

Zakeryaev A.B.

Research Institute — Ochapovsky Regional Clinical Hospital No.1

ORCID: 0000-0002-4859-1888

Vinogradov R.A.

Research Institute — Ochapovsky Regional Clinical Hospital No.1;
Kuban State Medical University

ORCID: 0000-0001-9421-586X

Sukhoruchkin P.V.

Research Institute — Ochapovsky Regional Clinical Hospital No.1

ORCID: 0000-0001-5385-338X

Butaev S.R.

Research Institute — Ochapovsky Regional Clinical Hospital No.1

ORCID: 0000-0001-7386-5986

Bakhishev T.E.

Research Institute — Ochapovsky Regional Clinical Hospital No. 1

ORCID: 0000-0003-4143-1491

Urakov E.R.

Research Institute — Ochapovsky Regional Clinical Hospital No. 1

Baryshev A.G.

Research Institute — Ochapovsky Regional Clinical Hospital No. 1;
Kuban State Medical University

SPIN RSCI: 2924-1648
ORCID: 0000-0002-6735-3877

Porkhanov V.A.

Research Institute — Ochapovsky Regional Clinical Hospital No. 1;
Kuban State Medical University

SPIN RSCI: 2446-5933
ORCID: 0000-0003-0572-1395

Received:

06.02.2022

Accepted:

02.05.2022

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References:

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