peripheral artery bypass
Jump to navigation
Jump to search
Indications
- peripheral vascular disease
- peripheral artery disease refractory to medical therapy
Procedure
- prosthetic or vein grafts
- prosthetic grafts associated with higher failure rate[2]
Complications
- 30-day unplanned readmission rate 18%, many due to post-operative infections[4]
Management
- aspirin 325 mg QD (after surgery)
- addition of warfarin to aspirin associated with increased morbidity from hemorrhage & overall mortality
- dual antiplatelet therapy (aspirin plus cloidogrel)
- more harm than benefit relative to aspirin alone for venous grafts
- may have benefits for prosthetic grafts[2]
More general terms
References
- ↑ Journal Watch 22(9):69, 2002 Johnson WC, Williford WO et al, Hemorrhagic complications during long-term postoperative warfarin administration in patients undergoing lower extremity arterial bypass surgery. J Vasc Surg 35:413, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/15895759
- ↑ 2.0 2.1 2.2 Belch JJF et al. Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial. J Vasc Surg 2010 Oct; 52:825 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20678878
- ↑ Lee CJ Infrapopliteal Bypass Technique. Medscape. April 11, 2017 http://emedicine.medscape.com/article/1895511-technique
- ↑ 4.0 4.1 Secemsky EA, Schermerhorn M, Carroll BJ et al Readmissions After Revascularization Procedures for Peripheral Arterial Disease: A Nationwide Cohort Study. Ann Intern Med. 2017;1-8. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29204656 <Internet> http://annals.org/aim/article-abstract/2665039/readmissions-after-revascularization-procedures-peripheral-arterial-disease-nationwide-cohort-study