8mm Conduit Outperforms 6mm Conduit in Extra-anatomic Bypass

Extra-anatomic bypass is an important tool in relieving supra-inguinal occlusive disease. These bypasses are frequently conducted with prosthetic material, commonly available 6-mm and 8-mm sizes. Previous studies have demonstrated infra-inguinal has improved patency when graft size 6 mm or greater. This study aimed to examine outcomes of vs use extra-anatomic bypasses. A retrospective analysis the Vascular Quality Initiative database (2010-2022) was conducted. Patients undergoing either axillary-femoral femoral-femoral conduit data were included. Primary endpoints included major adverse limb events (MALE). logistic regression performed demographic operative variables determine if any factors contributed selection size. Then, multivariable Cox groups based on diameter (6 8 mm), controlling for these factors. Seven excluded from formal due small sample but survival curves demonstrate stepwise impact total 6463 patients analysis; 2355 4128 Of these, 1071 underwent graft, 5392 graft. Significant predictors (P < .05) both types male gender, body mass index (BMI) 25-35 kg/m2, common femoral as distal target compared profunda, superficial artery, other vessels. The most significant predictor .001) primary examined larger (8 hazard ratio [HR], 0.5; HR, 0.66). by generated (Figs 1 2), which significantly higher over time. Improved performance additionally primary-assisted patency, secondary MALE P .001 In this bypasses, grafts had rates fewer Male sex associated use; after preoperative factors, still outperformed grafts. surgeons should be cognizant potential implications salvage selecting bypass.Fig 2Primary time size.View Large Image Figure ViewerDownload Hi-res image Download (PPT)