Background/Aim. Femoropopliteal bypass is a revascularization technique of
lower extremities with excellent outcome. The great saphenous vein is the
best graft material, but if it is not adequate or has been removed, synthetic
grafts are an useful alternative. Graft occlusion is the most significant
complication with the most serious consequences. The aim of this study was to
analyse predictive factors for the synthetic femoropopliteal bypass
occlusions. Methods. This retrospective case-control study included all
patients who underwent synthetic femoropopliteal bypass due to peripheral
arterial occlusive disease at the Vascular Surgery Center, Clinical Center of
Kragujevac, Serbia, from 2007 to 2013. The cases group were the patients with
femoropopliteal graft occlusion (n = 44), with the control group consisted of
the patients without such an outcome (n = 88). Results. Significant effects
to occlusion were: concomitant cardiovascular disease (adjustedOR 27.05; 95%
CI 4.74; 154.35), a type of femoropopliteal bypass (adjustedOR 16.50; 95% CI
4.05; 67.24), previous vascular intervention (adjustedOR 4.67; 95% CI 1.20;
18.14), clinical stage of the disease (adjustedOR 3.73; 95% CI 1.94; 7.18),
administration of postoperative oral anticoagulant therapy (adjustedOR 0.05;
95% CI 0.01; 0.23) and the use of angiotensin converting enzyme inhibitors
(adjustedOR 0.14; 95% CI 0.03; 0.70). A significant synergism was shown for
the following combinations of the observed risk factors: type of
femoropopliteal bypass and cardiovascular disease, type of femoropopliteal
bypass and previous vascular intervention, previous vascular intervention and
cardiovascular disease, previous vascular intervention and beta blockers,
cardiovascular disease and diabetes, type of femoropopliteal bypass and
antiaggregant therapy, clinical stage of disease and cardiovascular disease,
previous vascular intervention and antiaggregant therapy. Conclusion.
Concomitant cardiovascular disease, belowknee femoropopliteal bypass,
advanced stage of vascular disease and non-use of anticoagulant therapy and
angiotensin-converting enzyme inhibitors are the significant predictors of
graft occlusion after synthetic femoro-popliteal bypass. Their synergistic
effect determines the importance of diabetes, use of beta blockers and
platelet antiaggregant therapy.