Mechanical and biochemical factors influencing arterial reconstruction.

There are many factors which contribute to the outcome of arterial reconstruction--the site and extent of disease and its rate of progression as well as mechanical and biochemical factors. Mechanical influences are described in 10 patients in whom dilatation of their Dacron graft occurred between 1.4 and 4.5 years after reconstructive surgery. The outcome of arterial reconstruction has also been examined in relation to a number of biochemical risk factors. Only carboxyhaemoglobin levels (associated with cigarette smoking) were higher amongst those patients whose reconstructions failed during a 5-year follow-up compared with those whose reconstructions remained patient. There is little evidence that dietary advice is merited, but all patients should stop smoking cigarettes before elective arterial surgery.