{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T07:47:28Z","timestamp":1782373648973,"version":"3.54.5"},"reference-count":20,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Return to operating room (ROR) is an important quality metric reflecting surgical outcomes. This study aimed to identify risk factors associated with ROR after lower extremity bypass (LEB) for chronic limb-threatening ischemia (CLTI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was performed using the Society for Vascular Surgery Vascular Quality Initiative (SVS-VQI) database for patients undergoing LEB for CLTI between 2007 and 2020. Patients were divided into two groups: Group I (ROR) and Group II (No ROR). Univariate and multivariate regression analyses were conducted to identify risk factors, with significance set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 10\u2009800 patients, 1443 (14%) required ROR. Factors significantly associated with increased ROR risk included African American race (OR 1.39, CI [1.18-1.63]), Medicaid insurance (OR 1.36, CI [1.06-1.75]), ambulatory with assistance (OR 1.21, CI [1.05-1.41]), discharge to rehabilitation (OR 2.98, CI [2.58-3.44]), transfer to other hospitals (OR 4.06, CI [2.38-6.93]), concomitant bypass (OR 1.46, CI [1.05-2.03]), infrageniculate graft insertion (OR 1.39, CI [1.15-1.67]), non-autologous biologic conduit (OR 1.71, CI [1.25-2.33]), and general anesthesia (OR 2.58, CI [1.25-5.33]). Female sex (OR 0.82, CI [0.71-0.95]) and aspirin use (OR 0.85, CI [0.73-0.99]) were protective. Bypass thrombosis was the most common reason for ROR. No significant trend in ROR reduction was observed over the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multiple clinical and operative factors increase ROR risk after LEB for CLTI. Risk stratification and targeted interventions are essential to minimize complications and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261429440","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T19:36:43Z","timestamp":1772048203000},"page":"2198-2211","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Bypass Thrombosis is the Most Common Reason for Unplanned Return to Operating Room After Lower Extremity Bypass for Chronic Limb-Threatening Ischemia"],"prefix":"10.1177","volume":"92","author":[{"given":"Abdul Wasay","family":"Paracha","sequence":"first","affiliation":[{"name":"Penn State University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3573-7972","authenticated-orcid":false,"given":"Ahsan","family":"Zil-E-Ali","sequence":"additional","affiliation":[{"name":"Penn State Milton S. Hershey Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpha Ahamdou","family":"Tall","sequence":"additional","affiliation":[{"name":"Penn State University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob W.","family":"Soucy","sequence":"additional","affiliation":[{"name":"Penn State University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leana","family":"Dogbe","sequence":"additional","affiliation":[{"name":"Penn State University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Aziz","sequence":"additional","affiliation":[{"name":"Penn State Milton S. Hershey Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.02.016"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61249-0"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2207899"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1708538117721622"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574407306793"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.6233"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2016.10.021"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2571-2"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/M17-1058"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.3558"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.12.121"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.09.015"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.01.079"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2022.12.072"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2024.05.023"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2024.11.023"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.01.066"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574416666227"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.05.037"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-073290"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261429440","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261429440","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261429440","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T07:00:08Z","timestamp":1782370808000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261429440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/00031348261429440"],"URL":"https:\/\/doi.org\/10.1177\/00031348261429440","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]}}}