CORRELATION OF ATHEROSCLEROSIS PROGRESSION RATE AND GRAFT PATENCY PERIOD

Yu.L. Kazakov, A.V. Kargapolov, V.L. Yankovsky, P.V. Kuks
Department of Hospital Surgery and Inorganic Chemistry, State Medical Academy,
Tver, Russia

Results of reconstructive procedures in 781 patients with atherosclerotic occlusion of aortofemoral segment are presented. Graft obliteration was observed in 94 patients (13.7%). Retrospective review of 48 cases (51.1%) with graft occlusion caused by progressive atherosclerotic disease was made to reveal the correlation of transplant patency period, type of distal anastomosis and progression rate of obliterative process at the time of primary surgical procedure. In patients with active progression of atherosclerosis severe dyslipidemia was observed. These patients with distal end-to-side anastomosis demonstrated very short period of graft patency: 1.33±0.3 years compared with 7.2±0.8 years in control group. The authors conclude that results of aorto-femoral reconstruction directly depend on the progression rate of obliterative process at the time of reconstruction. End-to-side type of distal anastomosis in patients with dyslipidemia is functionally unfavorable.Combination of these unfavorable factors shortens the period of graft patency in 5.6 times. Complex evaluation of atherosclerosis progression must include clinical data as well as estimation of blood phospholipids level.

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