Analyzing The Relative Factors Of Occlusion Atfer Artificially Bypass Gratfing On Arteirosclerosis Obliterans

Objective: Analyzing the relative factors of restenosis and occlusion after artificiallybypass grafting on arteriosclerosis obliterans.To improve the patency rate of artificial bloodvessels, and to provide a better basis of evidence-based medicine. For preventing or educingthe restenosis and occlusion after artificially bypass grafting.Method:A total of253patients with lower limb arteriosclerosis obliterans in ChinaJapan Union Hospital of Jilin University from January2006to June2013under went theartificial blood vessel revascularization. Including the patient’s imaging tests, operationmethod and medical history were analyzed retrospectively. The patients were followed-upvisit and divided into patent group and occlusive group,according to their grafting potency indifferent post operation time. All the data were analyzed by SPSS19.0, the use ofmultiple-factor analysis, life table, kaplan-Meier, Classification variables data χ2teststatistical methods, determing the relative factors associated with the artificial vascularocclusion by analyzing the general situation for patients, preoperative complications,surgical method and spot, the outflow tract situation and postoperative medications.Result:Among253patients with artificially bypass grafting,1month,1year,2years,3years cumulative patency rates of aortoiliac or aortofemoral bypass were respectively93.5%,90.2%,85.5%,74.8%.1month,1year,2years,3years cumulative patency rates ofextra-anatomic bypass(femoro-femoral bypass and axillo-femoral artery bypass) wererespectively92.6%,73.2%,64.3%,59.3%. The patency rates of aortoiliac or aortofemoralbypass were higher than that of extra-anatomic bypass,but there was no significantdifference between them(P>0.05).The knee joint as the dividing line,1month,1year,2years,3years cumulative patency rates of femoropopliteal artery bypass to above-kneepopliteal(FP-ak) were94.0%、73.0%、66.0%、56.0%.1month,1year,2years,3yearscumulative patency rates of femoropopliteal artery bypass to below-knee popliteal (FP-bk) were89.1%、53.5%、41.6%、34.9%. The patency rates of FP-ak were significant higher thanthat of FP-bk(P<0.05).1month,1year,2years,3years cumulative patency rates of patientswith good run-off were97.0%、76.0%、69.0%、59.0%�'�83.3%. The same time, thecumulative patency rate of patients with poor run-off were83.3%、48.6%、38.9%、31.1%.Thepatency rates of patients with good outflow tract were significant higher than that of patientswith poor outflow tract (P<0.05).The long-term patency rates of femoropopliteal arteryartificially bypass on diabetes mellitus,smoking and regular oral antiplatelet drugs or nothave statistical significance(P<0.05). Intima hyperplasia of vascular anastomosis which wasfound in surgery after occlusion of artificially bypass grafting was the main factor leading torestenosis of vascular anastomosis or thrombosis.Conclusion:1.Early occlusion after artificially bypass grafting was related to inappropriate operationtechnique and immature vascular anastomosis technique.The middle and late occlusion weredue to stenosis of vascular anastomosis resulting from intimal hyperplasia and stenosis ofvascular anastomosis can lead to thrombus and arteriosclerosis.2.Diabetes mellitus，smoking and irregular oral antiplatelet drugs were the dangerousfactors which influenced the patency rate of femoropopliteal artery bypass.3.The key factors that affect the patency rate after artificially bypass grafting concludedthe distal anastomotic site and outflow situation.