A decade of oral anticoagulant treatment to maintain autologous vein grafts for femoropopliteal atherosclerosis
G. Kretschmer, F. Herbst, M. Prager, T. Sautner, E. Wenzl, G. A. Berlakovich, F. Zekert, L. Marosi and M. Schemper
Department of Surgery I, University of Vienna, Austria.
To determine whether long-term oral anticoagulant treatment was effective
in improving graft performance and preventing major amputation following
vein bypass surgery for femoropopliteal atherosclerosis, a clinical trial
was conducted in one single center and continued during 10 years. After 130
patients had electively received a femoropopliteal vein graft, they were
randomly assigned to a therapy group (treatment with phenprocoumon [n =
66]) or to a control group (n = 64) that remained without any anticoagulant
treatment. Primary end points of the study were graft reocclusion and limb
loss. The median durations of primary patency and limb salvage were
significantly longer for treated patients than that for controls. In
addition, survival in the therapy group was longer. Following autologous
vein bypass surgery in the treated group, the results were superior in
terms of graft patency, limb salvage, and survival.
