Document Detail


The efficacy of aspirin in patients undergoing infra-inguinal bypass and identification of high risk patients.
MedLine Citation:
PMID:  14612858     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Infrainguinal bypass is an effective treatment for critical lower limb ischemia but up to 1/3 of these grafts will occlude within the 1st year. The aim of this audit was to evaluate the efficacy of aspirin in maintaining graft patency and also improving patient survival. METHODS: In a single audited year (1997) 125 bypasses were carried out. Seventy-nine were on aspirin, 34 on no treatment and 12 were on other agents and hence excluded from analysis. The indication for surgery was critical ischaemia in 101 and disabling claudication in 12. Autologous vein was used in 104 and prosthetic grafts in 9. RESULTS: The overall 2-year primary graft patency, secondary graft patency and limb salvage were 50%, 71% and 83%, respectively. The 2-year secondary patency in patients with or without aspirin was 73% and 64%, respectively (p<0.12-log rank test). The corresponding patient survival from vascular death in the 2 groups was 73% and 70% (p<0.67-log rank test). Crural/ pedal bypass (51/75 on aspirin) and smoking (51/61 on aspirin) were independent risk factors for graft failure and vascular death respectively whilst those with a previous myocardial infarct (21/28 on aspirin) reached significance in univariate analysis only (p< 0.03). CONCLUSION: Aspirin was not a significant factor in preventing graft failure or vascular death in patients undergoing bypass for critical limb ischemia. Dual therapy with other antiplatelet agents needs to be considered in such patients particularly those undergoing crural/pedal bypass, smokers and those with a history of previous myocardial infarction.
Authors:
A Mahmood; M Sintler; A T Edwards; S R G Smith; M H Simms; R K Vohra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International angiology : a journal of the International Union of Angiology     Volume:  22     ISSN:  0392-9590     ISO Abbreviation:  Int Angiol     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-11-12     Completed Date:  2004-04-13     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  302-7     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, University Hospital Birmingham NHS Trust, Selly Oak Hospital, Birmingham, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aspirin / administration & dosage*
Blood Vessel Prosthesis Implantation / adverse effects*,  methods
Graft Occlusion, Vascular / etiology,  prevention & control*
Humans
Ischemia / surgery*
Lower Extremity / blood supply*
Medical Audit
Middle Aged
Peripheral Vascular Diseases / surgery
Platelet Aggregation Inhibitors / administration & dosage*
Risk Factors
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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