Pharmacotherapy to Improve Outcomes in Infrainguinal Bypass Graft Surgery: A Review of Current Treatment Strategies

A total of 12,000 infrainguinal bypass grafts are performed annually in the United Kingdom, with outcomes suboptimal: 20% of above-knee vein grafts require intervention by 3 years. Transatlantic Inter-Society Consensus (TASC) guidelines exist on pharmacological management of peripheral vascular disease patients, however, little is recommended regarding optimum pharmacological management following revascularization to improve graft patency. The current recommendation is that all patients are on an antiplatelet agent following bypass grafting, the only intervention with significant evidence supporting use.This article will review pharmacological strategies aimed at improving the survival of infrainguinal vein grafts and the current evidence base for their use.