• Athanasios D Giannoukas, Kosmas I Paraskevas, Stylianos Koutsias, Christos Argyriou, Vasilios Saleptsis, and Domenico Palombo.
• Department of Vascular Surgery, University Hospital of Larissa, University of Thessalia Medical School, Larissa, Greece giannouk@med.uth.gr.
• Angiology. 2014 Aug 1; 65 (7): 568-73.

AbstractWe investigated the role of oral vitamin K antagonists (VKAs) in graft patency, limb salvage, major and minor bleeding rates in patients undergoing infrainguinal bypass surgery. Five randomized-controlled trials (RCTs; n = 3746 patients) comparing VKA versus non-VKA treatment outcomes in patients undergoing infrainguinal bypass surgery were analyzed. The VKA treatment was associated with improved graft patency rates when a vein graft was used (risk ratio [RR]: 0.74; P = .0004), while there was no difference with prosthetic grafts (RR: 1.07; P = .39). The VKA treatment was also associated with improved limb salvage rates (RR: 0.33; P = .0008). Major and minor bleeding complications were higher in the VKA group. In conclusion, VKA treatment is associated with improved graft patency and limb salvage rates when a vein graft is used at the price of an increased risk of bleeding. Due to the inconsistent results, further well-designed RCTs are needed.© The Author(s) 2013.

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