PMID- 34549643
OWN - NLM
STAT- MEDLINE
DCOM- 20220309
LR  - 20220531
IS  - 1477-0377 (Electronic)
IS  - 1358-863X (Linking)
VI  - 27
IP  - 1
DP  - 2022 Feb
TI  - Impact of chronic kidney disease on the outcomes of infrapopliteal venous, and 
      heparin-bonded expanded polytetrafluoroethylene bypass surgeries: A retrospective 
      cohort study.
PG  - 55-62
LID - 10.1177/1358863X211036751 [doi]
AB  - The aim of this study was to analyze the results of infrapopliteal venous and 
      prosthetic bypass surgeries for patients with chronic limb-threatening ischemia 
      (CLTI) and moderate to severe chronic kidney disease (CKD). All consecutive 
      patients undergoing infrapopliteal bypass surgeries at two academic vascular 
      centers between March 2002 and November 2018 were included in this retrospective 
      study. During this timeframe, infrapopliteal grafts were performed for 487 
      patients. Of these patients, 160 (32.9%; group 1) had normal renal function, 248 
      (50.9%; group 2) had moderate CKD, and 79 (16.2%; group 3) had severe CKD 
      according to the Kidney Disease Improving Global Outcomes guidelines. After 5 
      years' follow-up, the primary patency rate was 46.0% and the secondary patency 
      rate was 54.9% without statistical significance noted between the CKD groups. 
      Limb salvage (65.3%, p = 0.024) and long-term survival (19.6%, p < 0.001) were 
      considerably lower in patients with severe CKD. In subgroup analysis, vein grafts 
      had significantly better long-term patency rates compared to prosthetic grafts, 
      regardless of CKD group. However, in patients with severe CKD, patency rates of 
      vein and heparin-bonded expanded polytetrafluoroethylene (HePTFE) grafts were 
      comparable at the 1-year mark. Our study shows that autologous vein grafts remain 
      the first choice for infrapopliteal bypass surgeries in patients with CKD. HePTFE 
      grafts showed good short-term results in patients with severe CKD. Given the 
      short life expectancy of these high-risk patients, prosthetic HePTFE grafts may 
      be reasonable in this population if a suitable vein is absent.
FAU - Betz, Thomas
AU  - Betz T
AUID- ORCID: 0000-0003-1539-245X
AD  - Department of Vascular Surgery, Barmherzige Bruder Hospital, Regensburg, Germany.
FAU - Toepel, Ingolf
AU  - Toepel I
AD  - Department of Vascular Surgery, Barmherzige Bruder Hospital, Regensburg, Germany.
FAU - Pfister, Karin
AU  - Pfister K
AD  - Department of Vascular Surgery, University Medical Center, Regensburg, Germany.
FAU - Lang, Malisia
AU  - Lang M
AD  - Department of Vascular Surgery, University Medical Center, Regensburg, Germany.
FAU - Steinbauer, Markus
AU  - Steinbauer M
AD  - Department of Vascular Surgery, Barmherzige Bruder Hospital, Regensburg, Germany.
FAU - Uhl, Christian
AU  - Uhl C
AD  - Department of Vascular Surgery, Barmherzige Bruder Hospital, Regensburg, Germany.
FAU - Zeman, Florian
AU  - Zeman F
AD  - Center for Clinical Studies, University Medical Center, Regensburg, Germany.
FAU - Schierling, Wilma
AU  - Schierling W
AD  - Department of Vascular Surgery, University Medical Center, Regensburg, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210922
PL  - England
TA  - Vasc Med
JT  - Vascular medicine (London, England)
JID - 9610930
RN  - 0 (Anticoagulants)
RN  - 9002-84-0 (Polytetrafluoroethylene)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants
MH  - Blood Vessel Prosthesis
MH  - *Blood Vessel Prosthesis Implantation
MH  - Heparin
MH  - Humans
MH  - Ischemia/diagnostic imaging/surgery
MH  - Polytetrafluoroethylene
MH  - *Popliteal Artery/diagnostic imaging/surgery
MH  - *Renal Insufficiency, Chronic/diagnosis
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Vascular Patency
OTO - NOTNLM
OT  - chronic kidney disease (CKD)
OT  - chronic limb-threatening ischemia (CLTI)
OT  - dialysis
OT  - heparin-bonded expanded polytetrafluoroethylene (HePTFE)
OT  - peripheral artery disease (PAD)
OT  - vascular surgery
EDAT- 2021/09/23 06:00
MHDA- 2022/03/11 06:00
CRDT- 2021/09/22 08:40
PHST- 2021/09/23 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/09/22 08:40 [entrez]
AID - 10.1177/1358863X211036751 [doi]
PST - ppublish
SO  - Vasc Med. 2022 Feb;27(1):55-62. doi: 10.1177/1358863X211036751. Epub 2021 Sep 22.