One-Week Postoperative Patency of Lower Extremity In Situ Bypass Graft Comparing Epidural and General Anesthesia: Retrospective Study of 822 Patients

Background The purpose of this study was to determine whether anesthesia affects graft patency after lower extremity arterial in situ bypass surgery. Methods This investigation was a retrospective study using a national database on vascular surgical patients at a single medical institution. We assessed a total of 822 patients exposed to infrainguinal in situ bypass vascular surgery over the period of January 2000 to September 2010. Results All patients included in the study (age [mean ± SD] 70.8 ± 9.7 years) underwent infrainguinal in situ bypass ( n = 885) for lower extremity revascularization under epidural ( n = 386) or general ( n = 499) anesthesia. Thirty-day mortality (3.4% for epidural anesthesia versus 4.4% general anesthesia; P = 0.414) and comorbidity were comparable in the 2 groups. Graft occlusion within 7 days after surgery was reported in 93 patients, with a similar incidence in the epidural (10.1%) and general (10.8%) anesthesia groups ( P = 0.730). When examining a subgroup of patients ( n = 242) exposed to surgery on smaller vessels (femorodistal in situ bypass procedures, n = 253), the incidence of graft occlusion was also similar in the 2 groups at 14.0% and 9.4%, respectively ( P = 0.262). Conclusion This retrospective study has shown that when graft patency is evaluated 7 days after surgery, anesthetic choice (epidural or general anesthesia) does not influence outcome.