Evaluation and Management of Peripheral
Annotation for Point U
When a complex (segmental resection with end-to-end anastomosis or insertion of interposition graft) or complicated (need for postarteriogram intervention) arterial repair has been performed, certain centers will infuse low-molecular-weight dextran at 40 mL/h for the first three postoperative days. There are only modest data to support the use of dextran, and none of it is recent.42 All patients with an end-to-end anastomosis, interposition graft, or when there is concern about distal runoff should be started on aspirin 81 mg or 162 mg orally daily at convenience. This recommendation is based on the long-term results when aspirin is administered after aortocoronary artery bypass with saphenous vein grafts.43,44 Instructions to the patient after arterial repair include a daily walking program and cessation of smoking.