Contemporary portrait of aortic bifurcated bypass procedures for occlusive disease in indian population: A transition in trends

Abstract

Purpose: We sought to scrutinize the current clinical profiles and postoperative outcomes, following aortic bifurcated bypass (ABB) for occlusive arterial disease, over the past ten years and compare them with our formerly published dataset. Methods: From January 2011 to December 2020, a prospective single hospital database was maintained for ABB procedures in patients with occlusive disease. Clinico-demographic profile and postoperative outcomes were surveyed and assessed for associations. Graft patency, amputation-free survival, and mortality were the primary end points. In addition, we did a comparison analysis with our historical cohort to appraise the shift in trends. Results: Over the past ten years, 140 patients (mean age of 54.5 years) underwent ABB procedures for aortoiliac occlusive disease (AIOD). Majority were males (94.3%) with chronic limb-threatening ischemia (88.6%). Atherosclerosis was the most common etiology (85.7%). There was a significant increase in smoking (P < 0.001), dyslipidemia (P < 0.001), coronary artery disease (P < 0.001), chronic kidney disease (P = 0.05), flow limiting infra-inguinal disease (P < 0.001), intermediate graft thrombosis and primary amputation rates in the contemporary cohort (P = 0.050). No significant changes were noted in the 30-day mortality rates. The contemporary primary patency rate is 76.9%, and secondary patency rate is 94.2%, compared to an overall patency of 84% in the historical cohort. Conclusion: Our study highlighted the epidemiological shift transpiring in patients affected by AIOD in India. Despite challenging clinical profiles, our outcomes remain unchanged and are comparable to western literature.

Keywords

• aorto-bifemoral bypass
• aortobifurcated bypass
• aorto-iliac occlusive disease
• graft patency