BMJ 1994;308:607-608 (5 March)

Editorials

Arterial bypass surgery and smokers

Whether smokers should be offered bypass surgery remains controversial despite the extensive airing the topic had in the BMJ's columns last year.1 Nearly all patients requiring such operations have smoked for long periods.2 Are there any benefits of giving up at this late stage?

With non-invasive techniques and objective markers of smoking it has been shown that one year after peripheral arterial bypass surgery the patency of femoropopliteal vein grafts in continuing smokers (63%) is significantly less than the patency of grafts in those who no longer smoke (84%).3 The results of prosthetic distal bypass surgery are similar - the chance of graft failure is doubled in smokers.4 Surveillance of the patency of coronary artery bypass grafts is more difficult, requiring serial angiography, and no study that has used objective markers of smoking has been reported. Nevertheless, some studies have reported an association between smoking and an increased risk of . . . [Full text of this article]


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Relevant Article

Vascular surgery in smokers Smokers must be allowed to decide
J Dawson and J Hotchkiss
BMJ 1994 308: 978-979. [Extract] [Full Text]

This article has been cited by other articles:

  • van Domburg, R. T., Meeter, K., van Berkel, D. F. M., Veldkamp, R. F., van Herwerden, L. A., Bogers, A. J. J. C. (2000). Smoking cessation reduces mortality after coronary artery bypass surgery: a 20-year follow-up study. J Am Coll Cardiol 36: 878-883 [Abstract] [Full text]  
  • Hasdai, D., Garratt, K. N., Grill, D. E., Lerman, A., Holmes, D. R. (1997). Effect of Smoking Status on the Long-Term Outcome after Successful Percutaneous Coronary Revascularization. NEJM 336: 755-761 [Abstract] [Full text]  
  • Higman, D. J., Strachan, A. M.J., Buttery, L., Hicks, R. C.J., Springall, D. R., Greenhalgh, R. M., Powell, J. T. (1996). Smoking Impairs the Activity of Endothelial Nitric Oxide Synthase in Saphenous Vein. Arterioscler. Thromb. Vasc. Bio. 16: 546-552 [Abstract] [Full text]  
  • Voors, A. A., van Brussel, B. L., Thijs Plokker, H.W., Ernst, S. M.P.G., Ernst, N. M., Koomen, E. M., Tijssen, J. G.P., Vermeulen, F. E.E. (1996). Smoking and Cardiac Events After Venous Coronary Bypass Surgery : A 15-Year Follow-up Study. Circulation 93: 42-47 [Abstract] [Full text]  
  • Dawson, J, Hotchkiss, J (1994). Vascular surgery in smokers Smokers must be allowed to decide. BMJ 308: 978-979 [Full text]  
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