The Impact of Oral Anticoagulants on Outcomes of Lower Extremity Bypass for Peripheral Vascular Disease

Patency rates of lower extremity bypasses at even one year are just 57% for PTFE and 77% for vein.1 There is no consensus on usefulness of anticoagulation to improve patency rates, and usage is based on anecdotal experience and a IIB level of recommendation.2 Direct oral anticoagulants (DOACs) are gaining popularity due to the ease of administration for patients, more consistent bioavailability, fewer known drug reactions, and the lack of need for frequent lab draws. Whereas there is inconsistent data with the use of warfarin on lower extremity interventions4-6, one small study showed promising results with the use of DOACs in patients with a disadvantaged runoff or with polytetrafluoroethylene grafts below the knee; with a mean follow up of 23 months, it showed primary patency rates of 100% for the patients with anticoagulation.3 There is a paucity of literature regarding the impact of different forms of novel oral anticoagulants on lower extremity bypasses. We plan to assess the benefits and risks of the different, frequently used anticoagulants on lower extremity bypasses using the Vascular Study Group of New England (VSGNE) datasets.

Aim: To investigate and compare the outcomes in terms of benefits and complications of different anticoagulants in patients undergoing infrainguinal bypasses