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Reassuring Intraoperative Parameters Do Not Obviate the Need for Infrainguinal Bypass Completion Angiograms.

Publication ,  Journal Article
Png, CYM; Kim, Y; Jessula, S; DeCarlo, CS; Waller, HD; Feldman, ZM; Sumpio, BJ; Lee, S; Dua, A; Srivastava, SD; Conrad, MF
Published in: Ann Surg
May 1, 2023

OBJECTIVE: To determine if routine completion angiography for lower extremity bypasses using vein conduit results in lower rates of postoperative bypass occlusion. SUMMARY OF BACKGROUND DATA: With the increasing availability of on-table angiography and significant advancements in endovascular techniques, some operators routinely perform completion angiograms. The effect of this surgical paradigm has yet to be rigorously compared to the more widespread selective use of completion imaging in the modern era. METHODS: This retrospective cohort study included infrainguinal arterial bypass procedures utilizing vein conduit completed at a single hospital system from 2001 to 2018 and compared postoperative outcomes between bypasses that underwent routine completion angiography versus selective completion angiography. Notably, any bypasses that underwent completion angiography due to intraoperative concerns were excluded from this analysis. RESULTS: 666 bypasses that were performed in 589 patients met inclusion criteria. 126 (16.9%) bypasses were classified into the routine completion angiogram group compared to 540 (81.0%) into the selective completion angiogram group. Patients who underwent routine completion angiograms had a rate of intraoperative reintervention of 22.2%. The routine angiogram group had lower rates of reintervention (3.9% vs 10.0%, P = 0.03) and graft occlusion (2.3% vs 9.2%, P = 0.01) at 1-month postoperatively. CONCLUSION: Lower extremity bypasses using vein conduit that undergo routine completion angiography are associated with lower rates of graft occlusion at 30-days postoperatively. Completion angiography should thus be routinely performed in infrainguinal bypasses that utilize venous conduit.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

May 1, 2023

Volume

277

Issue

5

Start / End Page

e1164 / e1168

Location

United States

Related Subject Headings

  • Vascular Patency
  • Treatment Outcome
  • Surgery
  • Saphenous Vein
  • Risk Factors
  • Retrospective Studies
  • Ischemia
  • Humans
  • Graft Occlusion, Vascular
  • Blood Vessel Prosthesis Implantation
 

Citation

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Png, C. Y. M., Kim, Y., Jessula, S., DeCarlo, C. S., Waller, H. D., Feldman, Z. M., … Conrad, M. F. (2023). Reassuring Intraoperative Parameters Do Not Obviate the Need for Infrainguinal Bypass Completion Angiograms. Ann Surg, 277(5), e1164–e1168. https://doi.org/10.1097/SLA.0000000000005363
Png, CY Maximilian, Young Kim, Samuel Jessula, Charles S. DeCarlo, H Davis Waller, Zachary M. Feldman, Brandon J. Sumpio, et al. “Reassuring Intraoperative Parameters Do Not Obviate the Need for Infrainguinal Bypass Completion Angiograms.Ann Surg 277, no. 5 (May 1, 2023): e1164–68. https://doi.org/10.1097/SLA.0000000000005363.
Png CYM, Kim Y, Jessula S, DeCarlo CS, Waller HD, Feldman ZM, et al. Reassuring Intraoperative Parameters Do Not Obviate the Need for Infrainguinal Bypass Completion Angiograms. Ann Surg. 2023 May 1;277(5):e1164–8.
Png, CY Maximilian, et al. “Reassuring Intraoperative Parameters Do Not Obviate the Need for Infrainguinal Bypass Completion Angiograms.Ann Surg, vol. 277, no. 5, May 2023, pp. e1164–68. Pubmed, doi:10.1097/SLA.0000000000005363.
Png CYM, Kim Y, Jessula S, DeCarlo CS, Waller HD, Feldman ZM, Sumpio BJ, Lee S, Dua A, Srivastava SD, Conrad MF. Reassuring Intraoperative Parameters Do Not Obviate the Need for Infrainguinal Bypass Completion Angiograms. Ann Surg. 2023 May 1;277(5):e1164–e1168.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

May 1, 2023

Volume

277

Issue

5

Start / End Page

e1164 / e1168

Location

United States

Related Subject Headings

  • Vascular Patency
  • Treatment Outcome
  • Surgery
  • Saphenous Vein
  • Risk Factors
  • Retrospective Studies
  • Ischemia
  • Humans
  • Graft Occlusion, Vascular
  • Blood Vessel Prosthesis Implantation