Smoking and arterial reconstruction.

Fasting levels of serum triglyceride, serum cholesterol, lipoprotein, uric acid, fibrinogen and carboxyhaemoglobin (COHb) were measured in 64 patients with stenosing arterial disease before reconstructive surgery, and were compared with those for normal, age- and sex-matched controls. All except fibrinogen were significantly higher in the patients with arterial disease than in the controls. The outcome of arterial reconstruction, assessed both clinically and by Doppler pressure measurement, was compared in terms of these risk factors. The reconstruction of 12 patients failed between 3 months and 5 years, leaving 52 patients with patent reconstructions at the end of the follow-up period. There was no difference between the two groups in terms of any of the risk factors, except for COHb. The COHb level (associated with inhalation of cigarette smoke) was significantly higher in the reconstruction failure group than in the reconstruction success group. We believe that patients should stop smoking cigarettes before reconstructive arterial surgery is undertaken.