The role of established and emerging risk factors in peripheral vascular graft occlusion

Abstract

Several studies have evaluated the association between established as well as emerging vascular risk factors with peripheral graft occlusion. There is evidence for a link between the risk for graft occlusion and total serum cholesterol, low-density lipoprotein cholesterol and triglyceride levels. The overall effect of smoking shows a 2.35-fold increase in risk of graft failure. Studies involving diabetic patients undergoing peripheral bypass may have failed to detect higher occlusion rates, possibly due to increased morbidity and mortality as well as higher amputation rates even if the graft is patent. Both antiplatelet agents and anticoagulation seem to be effective in the prevention of graft occlusion. Unconvincing data have been published with regards to the effect of hypertension on graft patency. Emerging factors such as fibrinogen, lipoprotein (a), C-reactive protein and homocysteine levels should also be considered when assessing the risk of graft occlusion. More research is needed to prevent graft occlusion due to the obvious clinical relevance, quality of life and cost issues.

One of the most urgent vascular circumstances: Acute limb ischemia

“…20 In addition, Lp(a) and other emerging factors such as fibrinogen, C-reactive protein, and homocysteine levels should be considered when assessing the risk of graft occlusion. 21…”

“…20 In addition, Lp(a) and other emerging factors such as fibrinogen, C-reactive protein, and homocysteine levels should be considered when assessing the risk of graft occlusion. 21 The incidence of peripheral arterial thrombembolization in the setting of transcatheter aortic valve implantation (TAVI) is not clearly known. In the setting of TAVI, debris from the calcified native aortic valve during the implantation of the new valve can embolize and obstruct peripheral arteries.…”

Do Different Vascular Risk Factors Affect All Arteries Equally?

“…25 T here is compelling evidence that established vascular risk factors (eg, smoking, hypertension, and hyperlipidemia) play an important role in the development of vascular disease. [1][2][3][4][5][6] There is also accumulating evidence supporting the role of several emerging risk factors (such as creatinine, fibrinogen, and C-reactive protein). [6][7][8][9] Modification of these risk factors may play a role in the pathogenesis of vascular disease.…”

Editorial [ Cardiovascular Risk Factor Modification: A sine qua non in the Management of Vascular Surgery Patients ]

“…There is also evidence for a link between hyperlipidemia and the outcome of vascular surgery operations (e.g. peripheral vascular graft occlusion) [36].…”