Pharmacological prophylaxis against postoperative graft occlusion after peripheral vascular surgery: a world-wide survey

Abstract

Objectives: To define current practice regarding the use of pharmacological prophylaxis to prevent postoperative graft occlusion.

Design: Prospective open questionnaire.

Materials and methods: Questionnaires regarding this subject were sent to vascular surgeons throughout the world to analyse current practice.

Results: 651 questionnaires were returned with a response rate of 62% and form the basis for this report. Data from 100,334 vascular reconstructions were reported in this survey. Prophylaxis against postoperative graft occlusions was common. Treatment periods were usually greater than 1 year. Among carotid surgery patients, 82% received prophylaxis, consisting mainly of low-dose acetysalicylic acid (ASA). In Mid-Europe the use of oral anticoagulation was more common than in other regions (p < 0.001). Among aneurysm surgery patients, 38% received prophylaxis. For infrainguinal bypass, ASA in low dose was the most commonly used agent worldwide. However, oral anticoagulation was more frequent in Mid-Europe, in contrast to South America where the combination of ASA and dipyridamole was most common. Considerable geographical differences regarding patient selection, the frequency of specific procedures and operative techniques existed.

Conclusions: Important world-wide differences exist regarding prophylaxis for postoperative graft occlusion.