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Effect of elastase on primary graft patency after femoralpopliteal arterial bypass for arteriosclerosis obliterans: a
1First Department of Surgery, Yamaguchi University School of Medicine, Japan.
Insights
Elastase combined with antiplatelet drugs may improve femoral-popliteal bypass graft patency, especially when using autogenous saphenous veins for arteriosclerosis obliterans (ASO). Further research is needed.
Area of Science:
- Vascular Surgery
- Pharmacology
- Biomedical Engineering
Background:
- Arteriosclerosis obliterans (ASO) commonly necessitates femoral-popliteal bypass surgery.
- Maintaining graft patency is crucial for successful long-term outcomes in bypass procedures.
Purpose of the Study:
- To evaluate the efficacy of elastase in conjunction with antiplatelet therapy for preserving femoral-popliteal bypass graft patency.
- To investigate the impact of elastase on graft patency rates in ASO patients.
Main Methods:
- A randomized controlled trial involving 104 patients with femoral-popliteal bypasses for ASO.
- Patients received either elastase plus an antiplatelet drug (Elastase group, 58 patients) or an antiplatelet drug alone (Control group, 46 patients).
- Follow-up ranged from 24 to 36 months across 22 Japanese institutions.
Main Results:
- The Elastase group showed a higher cumulative graft patency rate than the Control group, though not statistically significant.
- A significant improvement in cumulative graft patency was observed in the Elastase group when autogenous saphenous veins were utilized.
Conclusions:
- Elastase demonstrates potential efficacy in maintaining femoral-popliteal arterial bypass graft patency.
- The use of autogenous saphenous veins as grafts appears to enhance the effectiveness of elastase in preserving patency.
Methods:
Studies were carried out on 104 limbs with femoralpopliteal bypasses for arteriosclerosis obliterans (ASO). They were randomized to a group receiving elastase (10800 EL. U. P.O. per day) with an antiplatelet drug (Elastase group, 58 patients) or a group receiving only the antiplatelet drug (Control group, 46 patients). The follow-up period ranged from 24 to 36 months after operation at 22 institutions across Japan.
Results:
The cumulative graft patency rate was higher in the Elastase group than the Control group, but the difference lacked statistical significance. When autogenous saphenous veins were used, the cumulative graft patency rate was significantly higher in the Elastase group than the Control group.
Conclusions:
The present study suggests that elastase is effective in maintaining graft patency in femoralpopliteal arterial bypass when an autogenous saphenous vein is used as a graft.