Background Vein conduit is known to have better patency than prosthetic for infrainguinal bypass. Here we explore if racial disparities exist in infrainguinal bypass vein conduit use amid preoperative patient and systemic factors. Methods Retrospective Society for Vascular Surgery Vascular Quality Initiative data for 23,959 infrainguinal bypasses between 2003 and 2017 for occlusive disease were analyzed. For homogeneity, only infrainguinal bypasses originating from the common femoral artery were included. Demographics of patients receiving vein vs prosthetic were compared and logistic regression analyses were performed with race and preoperative factors to evaluate for predictors of vein conduit use. Results Adjusted regression models demonstrated black patients were 76% as likely (p < .001) and Hispanic patients 79% as likely (p = .003) to have vein conduit compared to white patients. Factors positively correlating with vein use included vein mapping, more distal bypass target, tissue loss or acute ischemia bypass indications, commercial insurance, and weight. Factors against vein use included advanced age, female gender, ASA class 4, urgent procedure, preoperative mobility limitation, prior CABG or leg bypass, prior smoking, preoperative anticoagulation, and a bypass performed in the Southern US or before 2012. While black and Hispanic patients were less likely to receive vein, they were vein mapped at similar or higher rates than other groups. Conclusion Racial disparities exist in conduit use for infrainguinal bypass, with black and Hispanic patients less likely to receive vein bypasses. However, the contribution of race to conduit selection is small in adjusted and unadjusted models. Overall, pre-operative variables in the Vascular Quality Initiative poorly predicted vein conduit use for infrainguinal bypass.

中文翻译：

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在血管外科协会血管质量倡议中检查种族和腹股沟下旁路导管的使用

背景 已知静脉导管在腹股沟下旁路中比假肢具有更好的通畅性。在这里，我们探讨在术前患者和全身因素中腹股沟下旁路静脉导管的使用是否存在种族差异。方法 回顾性血管外科学会血管质量倡议数据分析了 2003 年至 2017 年间 23,959 例因闭塞性疾病进行的腹股沟下旁路手术。为了均匀性，仅包括源自股总动脉的腹股沟下旁路。比较接受静脉与假肢的患者的人口统计学特征，并使用种族和术前因素进行逻辑回归分析，以评估静脉导管使用的预测因素。结果调整后的回归模型表明，黑人患者的可能性为 76% (p < .001)，西班牙裔患者的可能性为 79% (p = .001)。003) 与白人患者相比有静脉导管。与静脉使用呈正相关的因素包括静脉映射、更远侧旁路目标、组织损失或急性缺血旁路适应症、商业保险和体重。反对静脉使用的因素包括高龄、女性、ASA 4 级、紧急手术、术前活动受限、既往 CABG 或腿部搭桥术、既往吸烟、术前抗凝以及在美国南部或 2012 年之前进行的搭桥手术。而黑人和西班牙裔患者接受静脉的可能性较小，他们的静脉映射率与其他组相似或更高。结论 腹股沟下旁路的导管使用存在种族差异，黑人和西班牙裔患者不太可能接受静脉旁路。然而，在调整和未调整的模型中，种族对管道选择的贡献很小。总体而言，血管质量倡议中的术前变量无法预测静脉导管用于腹股沟下旁路术。