Active smoking in claudicants undergoing lower extremity bypass predicts decreased graft patency and worse overall survival

Abstract

Despite the fact that smokers are younger and have fewer comorbidities than nonsmokers, active smoking at the time of LEB for claudication is associated with decreased long-term patency and decreased overall survival. Surgeons should consider smoking an important risk factor for worse LEB outcomes in smokers compared with nonsmokers.

Gender, Racial, and Ethnic Disparities in Index Hospitalization Operations for Symptomatic Carotid Stenosis in Texas Hospitals

“…Commentary: Previous studies have demonstrated the importance of smoking cessation concerning lower extremity arterial bypass patency. [1][2][3] The current study shows the negative impact smoking has on endovascular and hybrid procedures also. We should keep in mind that these results were present even as soon as 30 days after the procedure; long-term follow-up would likely show even more deleterious effects of smoking on arterial interventions.…”

Quantifying the risk-adjusted hospital costs of postoperative complications after lower extremity bypass in patients with claudication

“…Current tobacco use was prevalent in 36.7% of patients in our study. Active smoking at LEB for claudication has been associated with decreased longterm patency and overall survival, 24 suggesting that elective open revascularization in these patients should receive additional scrutiny. It is concerning that more than one third of the patients in our study were active smokers, highlighting the substantial room for improvement present in the medical management of claudication.…”

Vein Versus Prosthetic Graft for Femoropopliteal Bypass Above the Knee: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…It has been shown that in patients treated with prosthetic above-knee femoropopliteal bypasses, the graft patency rates are higher and the amputation rates lower when the indication for surgery is claudication as opposed to critical ischemia. 27 Jones et al 28 analyzed 1789 infrainguinal bypasses for claudication and demonstrated that active smoking is an independent risk factor for prediction of reduced primary and primary assisted graft patency and overall survival. Even at 1-year follow-up, Jafarian et al 29 demonstrated the negative effect of smoking on graft patency.…”