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

Abstract

To define current practice regarding the use of pharmacological prophylaxis to prevent postoperative graft occlusion. Prospective open questionnaire. Questionnaires regarding this subject were sent to vascular surgeons throughout the world to analyse current practice. 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. Important world-wide differences exist regarding prophylaxis for postoperative graft occlusion.