THE ANALYSIS OF RISK FACTORS FOR THE SYNTHETIC FEMOROPOPLITEAL BYPASS GRAFT OCCLUSIONS

ABSTRACT INTRODUCTION. Femoropopliteal bypass is revascularization technique of lower extremities with excellent outcome. AIM. The aim of this study was to analyse predictive factors for the synthetic femoropopliteal bypass occlusions. METHODS. This retrospective case-control study included all patients who underwent synthetic femoropopliteal bypass due to peripheral arterial occlusive disease at the Vascular Surgery Center, Clinical Center of Kragujevac, Serbia, from 2007 to 2013. The cases group were patients with femoropoliteal graft occlusion, and a control group consisted of patients without such an outcome. RESULTS. Significant effects for the occlusions were found for the concomitant cardiovascular disease( adjusted OR 27.05; 95%CI 4.74, 154.35), type of femoropopliteal bypass( adjusted OR 16.50; 95%CI 4.05, 67.24),  previous vascular intervention( adjusted OR 4.67; 95%CI 1.20, 18.14), clinical stage of disease ( adjusted OR 3.73; 95%CI 1.94, 7.18), the administration of postoperative oral anticoagulant therapy( adjusted OR 0.05; 95%CI 0.01, 0.23) and angiotensin converting enzyme inhibitors( adjusted OR 0.14 ; 95%CI 0.03, 0.70). A significant synergism was shown for the following combinations of observed risk factors: type of femoropopliteal bypass and cardiovascular disease, type of femoropopliteal bypass and previous vascular intervention, previous vascular intervention and cardiovascular disease, previous vascular intervention and beta blockers, cardiovascular disease and diabetes, type of femoropopliteal  bypass and antiaggregant therapy, clinical stage of disease  and car diovascular disease, previous vascular intervention and  antiaggregant therapy. CONCLUSIONS. Concomitant cardiovascular disease, below-knee femoropopliteal bypass, advanced stage of vascular disease and non-use of anticoagulant therapy and  angiotensin converting enzyme inhibitors were significant predictors of graft occlusion after synthetic femoropopliteal bypass. Synergistic effect has determined the importance of diabetes, use of beta blockers and platelet antiaggregant therapy. Earlier clinical stage of vascular disease, above-knee type of femoropopliteal  bypass, adequate treatment of chronic comorbidities with appropriate  therapy reduces the risk of graft occlusion. KEY WORDS : femoropopliteal bypass; synthetic; graft occlusion; predictive factors;