All end points were independently adjudicated by two cardiologists blinded to treatment assignment. The secondary end point was the hospital length of stay after surgery. The primary end point was the development of AF in the postoperative period. There is growing clinical evidence that PUFAs have cardiac antiarrhythmic effects.Ī total of 160 patients were prospectively randomized to a control group (81 patients, 13 female, 64.9 +/- 9.1 years) or PUFAs 2 g/day (79 patients, 11 female, 66.2 +/- 8.0 years) for at least 5 days before elective CABG and until the day of discharge from the hospital. Postoperative AF is a common complication of CABG. All rights reserved.The aim of this study was to assess the efficacy of preoperative and postoperative treatment with n-3 polyunsaturated fatty acids (PUFAs) in preventing the occurrence of atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG). BSX with vein offers the best long term AFS and OS and, overall, BAP appears superior to prosthetic BSX.Ĭrown Copyright (c) 2010. BSX outcomes after failed BAP are significantly worse than for BSX performed as a first revascularization attempt. Most BAP patients ultimately required surgery. AFS (P = 0.006) but not OS (P = 0.06, log rank test) survival was significantly worse after BSX after failed BAP than after BSX as a first revascularization attempt.īAP was associated with a significantly higher early failure rate than BSX. There were no differences in outcome between approximately equal numbers of transluminal and subintimal BAP.
Outcome of vein BSX was better for AFS (P = 0.003) but not OS (P = 0.38, log-rank tests) than prosthetic BSX. Most (80%) BAP patients underwent treatment of the SFA alone (38%) or combined with the popliteal artery (42%) and crural arteries (20%). About 25% of the grafts were prosthetic and >90% of vein BSX used ipsilateral great saphenous vein. BSX distal anastomoses were divided approximately equally between the above and below knee popliteal and crural arteries most originated from the common femoral artery. By 12 weeks after randomization 9 BAP (4%) vs 23 BSX (10%) patients had not undergone revascularization 3 BAP (1.3%) vs 13 BSX (5.8%) had undergone the opposite treatment first and 35 BAP (15.6%) and 2 (0.9%) BSX had received the assigned treatment and then undergone the opposite treatment. BAP had a higher immediate technical failure rate of 20% vs 2.6% (P =. Patients randomized to BAP were more likely to have their assigned treatment first (94% vs 85%, P =. We prospectively collected data on every procedure, major amputation, and death. All patients have been monitored for 3 years and more than half for >5 years. We randomly assigned 452 patients with SLI due to infrainguinal disease in 27 United Kingdom hospitals to a BSX first (n = 228) or a BAP first (n = 224) revascularization strategy. We also compare vein with prosthetic BSX and transluminal with subintimal balloon angioplasty (BAP) and examine outcomes from BSX after failed BAP. We describe the nature and timing of first, crossover, and reinterventions and examine AFS and OS by first treatment received. P Bachoo, J Brittenden, G Cooper, S Cross, J Engeset, J Hussey, E Macauley, P Thorpe, G Stewart, K Osbourne, J Moss, P Nicholl, S Silverman, J Wingate, G Adam, B Balasubramanian, A Bradbury, P Crowe, J Ferrando, M Gannon, M Henderson, K Makhdoomi, D Mosquera, T Wilmink, T Buckenham, R Chalmers, R Dawson, S Fraser, I Gillespie, S Ingram, A Jenkins, J Muric, Z Raza, N Jones, D Lambert, T Lees, R Owen, J Rose, G Stansby, M Wyatt, D Byrne, R Edwards, A MacKay, J Moss, R Quin, P Rogers, D Gilmour, D Leiberman, D McCarter, Reid, S Dodds, M Cleesby, A Jewkes, B Jones, C Nelson, A Parnell, P Bell, A Bolia, N Chalmers, I Mohan, V Smyth, M Walker, M Collins, A Garnham, G Mackie, P Stonebridge, J Houston, M Armon, J Clarke, J Cockburn, J Colin, S Girling, S Scott-Barrett, P Wilson, Y Wilson, J Beard, T Cleveland, P Chan, P Gaines, R Lonsdale, J Michaels, A Nassif, R Niar, J Rochester, S Thomas, R Wood, A Ashour, V Bhattacharya, A Nudawi, G Timmons, A Howd, M Fleet, H Ireland, K McBride, A Milne, A Turner, G Ferguson, M Onwudike, R Razzaq, T Tuck, D Baker, G Hamilton, F Hyint, A Platts, J Tibballs, A Watkinson, K Choji, R Grimley, A Jayatunga, R Patel, J Renny, S Shiralkar, A Wilinski, M Alner, M Duddy, A Edwards, M Simms, S Smith, R Vohra, G MacBain, R Johnstone, G Urquhart, G Welch, D Durrans, B Gwynn, C Willard, M Thompson, R Morgan, J Patel, J Scott, I Spark, K Allen, A Khan, J Holland, R Ashleigh, S Butterfield, R England, C McCollum, A Nasim, M WelchĪn intention-to-treat analysis of randomized Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial data showed that initial randomization to a bypass surgery (BSX)-first strategy was associated with improvements in subsequent overall survival (OS) and amputation-free survival (AFS) of about 7 and 6 months, respectively.