Related Experiment Video
Updated: Jun 23, 2026
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Disparity in outcomes of surgical revascularization for limb salvage: race and gender are synergistic determinants of
Louis L Nguyen1, Nathanael Hevelone, Selwyn O Rogers
1Division of Vascular and Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, CA 94143-0222, USA.
Black race and female gender increase risks for vein bypass graft failure and limb loss in peripheral bypass surgery. Black women face the highest risk, indicating potential biological differences requiring further study.
Area of Science:
- Vascular Surgery
- Health Disparities Research
- Biomedical Engineering
Background:
- Vein bypass surgery is crucial for atherosclerotic occlusive disease but faces graft patency limitations.
- Graft failure in critical limb ischemia leads to significant morbidity, limb loss, and increased healthcare costs.
- Patient-specific risk factors, particularly race and gender, influencing peripheral bypass outcomes remain controversial.
Purpose of the Study:
- To investigate the impact of race and gender on outcomes following peripheral vein bypass surgery for critical limb ischemia.
- To identify specific demographic groups at higher risk for adverse events such as graft failure and limb loss.
Main Methods:
- Analysis of the Project of Ex Vivo Vein Graft Engineering via Transfection III (PREVENT III) randomized trial database (1404 lower extremity vein graft operations).
- Utilized multivariable modeling (Cox proportional hazards and propensity score) to assess demographic variables against clinical endpoints up to 1 year.
- Adjusted for 16 covariates including institutional type, technical factors, comorbidities, and medications to isolate race and gender associations.
Main Results:
- Black men showed increased risk for early graft failure (30-day HR 2.832) and reduced 1-year secondary patency and limb salvage.
- Black patients experienced significantly lower limb salvage rates (HR 2.02) at 1 year.
- Black women faced the highest risk, with increased graft patency loss (HR 2.02) and major amputation (HR 2.38) at 1 year; perioperative and 1-year mortality were similar across groups.
Conclusions:
- Black race and female gender are identified as significant risk factors for adverse outcomes in peripheral vein bypass surgery.
- Graft failure and limb loss are more prevalent in Black patients, with Black women representing a particularly high-risk demographic.
- Observed disparities suggest potential altered biological responses to vein grafting, warranting further investigation into underlying mechanisms.
More Related Videos
07:02A Rabbit Venous Interposition Model Mimicking Revascularization Surgery using Vein Grafts to Assess Intimal Hyperplasia under Arterial Blood Pressure
Published on: May 15, 2020
08:16High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model
Published on: March 16, 2022
Related Concept Videos
01:15Veins of Lower Limbs
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the knee,...
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
01:27Peripheral Artery Disease III: Interprofessional Care
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care