Isa Bolat, Ugur Karagoz, Tunay Kurtoglu
Turkish Journal of Vascular Surgery - 2025;34(3):204-211
Aim: Peripheral arterial disease (PAD) is caused by atherosclerosis and affects the lower extremity arteries. Surgical methods including infrainguinal bypass play an indispensable role in the treatment of PAD. We aimed to investigate the long-term outcomes of femoropopliteal bypass surgery primarily focusing on survival, amputation and graft related complications (thrombosis and graft infection). Material and Methods: A total of 77 patients who underwent isolated femoropopliteal bypass surgery between January 2015 and January 2022 were retrospectively analyzed. Clinical characteristics and demographic data of the patients, preoperative and postoperative Rutherford categories were noted. Amputation, survival, and graft-related complication rates were reviewed. Results: During the follow-up period (average of seven years), the overall mortality was 44.2%. Overall survival rates were observed to be lower in patients with chronic renal failure (p<0.05). A significant decrease of postoperative Rutherford stages were found compared to the preoperative stages (p <0.001). Amputation occured in 37.6% of the cases and the rate of graft-related complications were 11.6%. The graft-related complications were found to be significantly lower in autogenous vein grafts compared to prosthetic grafts (p<0.01). The graft type had no significant effect on amputation-free survival. However major amputation-free survival was observed to be higher in cases when a vein graft was used (p=0.02). Conclusion: Femoropopliteal bypass surgery provides a significant improvement in the clinical severity of chronic PAD. The use of saphenous vein grafts provides benefit to reduce graft-related complications and improve major amputation-free survival. Keywords: Femoropopliteal bypass, risk factors, graft failure
