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Routine Completion Angiography for Infrainguinal Bypasses Using Prosthetic Conduit: No Effect on Postoperative
C Y Maximilian Png1, Charles S DeCarlo1, Brandon T Gaston1
1Department of Surgery, Massachusetts General Hospital, Boston, MA.
Annals of Vascular Surgery
|March 11, 2023
Summary
Routine completion angiography in prosthetic bypasses does not improve graft patency. While many bypasses required revision after angiography, this did not lead to better 30-day outcomes for prosthetic grafts.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Medical Imaging
Background:
- Routine completion angiography (RCA) improves venous bypass patency.
- Prosthetic conduits have fewer technical issues than venous conduits.
- The impact of RCA on prosthetic bypass patency is understudied.
Purpose of the Study:
- To evaluate the effect of routine completion angiography on prosthetic bypass patency.
- To compare routine versus selective completion imaging for prosthetic infrainguinal bypasses.
Main Methods:
- Retrospective review of 498 infrainguinal prosthetic bypasses (2001-2018).
- Analysis of demographics, comorbidities, reintervention rates, and 30-day graft thrombosis.
- Statistical analysis using t-tests, chi-square, and Cox regression.
Main Results:
- 21.4% of routine completion angiogram cases required intraoperative reintervention.
- No significant difference in 30-day reintervention rates (3.5% vs. 4.5%) between groups.
- No significant difference in 30-day graft occlusion rates (3.5% vs. 4.7%) between groups.
Conclusions:
- Routine completion angiography in prosthetic bypasses often leads to revision.
- Postangiogram revision does not improve 30-day graft patency for prosthetic bypasses.
- Selective completion imaging may be sufficient for prosthetic infrainguinal bypasses.
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