Analysis of Risk Factors for the Development of Femoropopliteal Bypass Graft Occlusions

Variable		Cases (n=35)	Controls (n=70)	Test value and significance of null hypothesis	*Crude odds ratios with confidence intervals (1.96SE)**
Sex(M/F)		27/8 (77%/23%)	53/17 (76%/24%)	χ² = 0.26	1.08 (0.41, 2.83)
p = 0.871
Age (years, mean ± SD)		65.00 ± 7.92	63.79 ± 10.02	T = 0.626	1.01 (0.97, 1.06)
p = 0.533
Clinical stage of disease according to Rutherford	I	0 0%	7 10%	χ² = 25.848	2.82 (1.77, 4.48)
	II	0 0%	16 22%	p < 0.001*
	III	6 17%	21 30%
IV	11 31%	13 19%
V	15 43%	13 19%
VI	3 9%	0 0%
Duration of smoking (years, mean ± SD)		28.03 ± 16.08	26.51 ± 17.03	U=1213,000	1.01 (0.98, 1.03)
p = 0.934
Alcohol consumption		8/27 (23%/77%)	18/52 (26%/74%)	χ² = 0.102	0.86 (0.33, 2.22)
p = 0.749
Form of femoropopliteal bypass (below-knee vs above-knee)		25/10 (71%,29%)	22/48 (31%, 69%)	χ² = 15.099	5.45 (2.24, 13.28)
p < 0.001*
Anticoagulant(AC) and Antiaggregant (AA) therapy		AC+AA 23 66%	AC+AA 34 49%	χ² =4.001	0.58 (0.31, 1.11)
		AC 11 31%	AC 29 41%	p = 0.261
		AA 0 0%	AA 4 6%
without	without
AA/AC 3 3%	AA I AC 3 4%
Type of heparin		SH 28 80%	S 54 77%	χ² = 0.274	0.85 (0.42, 1.71)
Type of heparin		LMWH 5 14%	LMWH 10 14%	p = 0.872	0.85 (0.42, 1.71)
S+LMWH 2 6%	S+LMWH 6 9%
Preoperative levels of haemoglobin		128.91 ± 20.85	133.67 ± 19.98	T = −1.134	0.99 (0.97, 1.01)
p = 0.260
Preoperative levels of aPTT		28.12 ± 5.11	27.92 ± 6.27	U = 1157.500	1.01 (0.94, 1.08)
p = 0.646
Preoperative levels of INR		1.14 ± 0.30	1.08 ± 0.38	U = 1067.000	1.57 (0.51, 4.89)
p = 0.283
Preoperative levels of hematocrit		38.57 ± 6.36	40.18 ± 5.67	T = −1.323	0.95 (0.891, 1.023)
p = 0.189
Aortoiliac stenosis		6/29 (17%/83%)	18/52 (26%/74%)	χ² = 0.972	0.60 (0.21, 1.67)
p = 0.324
Previous vascular intervention		9/26 (26%/74%)	13/57 (19%/81%)	χ² = 0.719	1.52 (0.58, 4.00)
p = 0.397
Angiotensin converting enzyme (ACE) inhibitors		24/11 (69%/31%)	50/19 (71%/29%)	χ² = 0.677	0.80 (0.33, 1.94)
p = 0.713
Beta blockers		16/19 (46%/54%)	28/42 (40%/60%)	χ² = 0.313	1.26 (0.56, 2.86)
p = 0.576
Diuretics		11/24 (31%/69%)	24/46 (34%/66%)	χ² = 0.086	0.88 (0.37, 2.09)
p = 0.770
Calcium channel blockers		6/29 (17%/83%)	17/53 (24%/76%)	χ² = 0.696	0.64 (0.23, 1.82)
p = 0.404
Metformin		2/33 (6%/94%)	14/56 (20%/80%)	χ² = 3.687	0.24 (0.05, 1.13)
p = 0.055
Insulin		5/30 (14%/86%)	9/61 (13%/87%)	χ² = 0.041	1.13 (0.35, 3.67)
p = 0.839
Type of graft (artificially vs venous)		32/3 (91%/9%)	61/9 (87%/13%)	χ² = 0.423	1.57 (0.40, 6.22)
p = 0.515
Finnvastic score		5/30 (14%/86%)	5/65 (7%/93%)	χ² = 1.382	2.17 (0.58, 8.05)
p = 0.295
Cardiovascular diseases		20/15	26/44	χ² = 3.791	2.26 (0.98, 5.16)
57%/43%	37%/63%	p = 0.052
Chronic renal insufficiency		5/30	4/66	χ² = 2.188	2.75 (0.69, 10.97)
14%/86%	6%/94%	p = 0.156
Peptic ulcer disease		5/30	5/65	χ² = 1.382	2.17 (0.58, 8.05)
14%/86%	7%/93%	p = 0.295
Number of angiographically passable crural recipient arteries		16/9/8	15/28/21	χ² = 6.359	1.75 (1.01, 3.06)
48,5%/27,3%/24,2%	32,8%/43,8%/23,4%	p = 0.042*
1/2/3
Diabetes		11/24	23/47	χ² = 0.022	0.94(0.39, 2.24)
31%/69%	33%/67%	p = 0.883
Malignancy		0/35	5/65	χ² = 2.625	0.00
0%/100%	7%/93%	p = 0.167
Perioperative blood transfusion		6/29	9/61	χ² = 0.350	1.40 (0.46, 4.31)
17%/83%	13%/87%	p = 0.554
Alpha blockers		2/33	2/68	χ² = 0.520	2.06 (0.28, 15.28)
6%/94%	3%/97%	p = 0.471

* Significant difference

SD= Standard Deviation

AC =Anticoagulants

AA = Antiaggregant

SH = Standard heparin

LMWH = Low molecular weight heparin

aPTT = Activated Partial Thromboplastin Time;

INR = international Normalized Ratio;

ACE = Angiotensin Converting Enzyme;

Table II.

Crude and adjusted odds ratios of the risk factors for femoropopliteal bypass graft occlusions*

Risk factors	Crude OR (95% CI)	Adjusted OR (95% CI)
Form of femoropopliteal bypass (below-knee vs above-knee)	5.45(2.24, 13.28)	115.34(4.02, 3306.55)
Type of graft (artificially vs venous)	1.57(0.40, 6.22)	81.62(1.03, 6486.32)
Cardiovascular diseases	2.26(0.98, 5.16)	55.64(2.63, 1176.94)
Previous vascular intervention	1.52(0.58, 4.00)	51.61(1.10, 2425.14)
Clinical stage of disease according to Rutherford	2.82(1.77, 4.48)	22.21(2.62, 188.39)
Preoperative levels of haemoglobin	0.99(0.97, 1.01)	1.33(1.01, 1.74)
Preoperative levels of hematocrit	0.95(0.89, 1.02)	0.34 (0.13, 0.98)

* For the sake of clarity only significant associations are shown in the table (95% CI of adjusted OR does not include value of 1)

OR = Odds Ratio;

CI = Confidence Intervals

Table III.

Synergistic effects of risk factors for the femoropopliteal bypass graft occlusions

Risk factors	Crude OR (95% CI)	Adjusted OR (95% CI)
Form of femoropopliteal bypass (below-knee vs above-knee)	5.45(2.24, 13.28)	115.34(4.02, 3306.55)
Type of graft (artificially vs venous)	1.57(0.40, 6.22)	81.62(1.03, 6486.32)
Cardiovascular diseases	2.26(0.98, 5.16)	55.64(2.63, 1176.94)
Previous vascular intervention	1.52(0.58, 4.00)	51.61(1.10, 2425.14)
Clinical stage of disease according to Rutherford	2.82(1.77, 4.48)	22.21(2.62,188.39)
Preoperative levels of haemoglobin	0.99(0.97, 1.01)	1.33(1.01, 1.74)
Preoperative levels of hematocrit	0.95 (0.89, 1.02)	0.34 (0.13, 0.98)
Form of femoropopliteal bypass(below-knee vs above-knee) by Type of graft (artificially vs venous)	5.54(2.30,13.35)	140.95(5.47, 3632.14)*
p=0.003
Type of graft (artificially vs venous) by Previous vascular intervention	1.50(0.52,4.35)	75.96(1.14, 5060.94)*
p=0.043
Cardiovascular diseases by Form of femoropopliteal bypass(below-knee vs above-knee)	4.50(1.75,11.60)	68.03(3.14, 1472.69)*
p=0.007
Type of graft (artificially vs venous) by Cardiovascular diseases	2.03(0.89,4.64)	25.71(1.69, 391.30)*
p=0.019
Previous vascular intervention by Form of femoropopliteal bypass(below-knee vs above-knee)	2.70(0.76,9.53)	4.22(0.20, 90.46)
p=0.357
Type of graft (artificially vs venous) by Clinical stage of disease according to Rutherford	1.86(1.39,2.61)	2.83 (1.28, 6.24)*
p=0.010
Clinical stage of disease according to Rutherford by Form of femoropopliteal bypass(below-knee vs above-knee)	1.65(1.32,2.05)	2.58(1.47, 4.51)*
p=0.001
Preoperative levels of haemoglobin by Form of femoropopliteal bypass(below-knee vs above-knee)	1.01(1.01,1.02)	1.02(1.01,1.04)
p=0.008
Preoperative levels of hematocrit by Form of femoropopliteal bypass(below-knee vs above-knee)	1.04(1.02,1.06)	1.06(1.02,1.12)
p=0.009
Preoperative levels of haemoglobin by Preoperative levels of hematocrit	1.00(1.00–1.00)	1.00(0.99,1.00)
p=0.381

* Clinically significant interaction

OR = Odds Ratio

CI = Confidence Interval

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DOI: https://doi.org/10.2478/sjecr-2021-0085 | Journal eISSN: 2956-2090 (formerly 2335-075X, 2956-0454) | Journal ISSN: 2956-0454 (formerly 1820-8665)

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Language: English

Submitted on: May 27, 2021

Accepted on: May 27, 2021

Published on: Nov 5, 2025

Published by: University of Kragujevac, Faculty of Medical Sciences

In partnership with: Paradigm Publishing Services

Keywords:

Femoropopliteal bypass,

Related subjects:

Clinical medicine, other

© 2025 Nikola Mirkovic, Srdjan Stefanovic, Snezana Sretenovic, Slobodan Jankovic, published by University of Kragujevac, Faculty of Medical Sciences
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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