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Taste of Boston
Taste of Boston

P1: Plenary Session 1: William J. von Liebig Forum

RS03 - Preoperative Chemotherapy and Risk of Complications Following Lower Extremity Revascularization

Wednesday, June 10, 2026
9:00 AM - 9:07 AM ET
Location: Hynes CC, Third Level, Ballroom B

    Submitting & Presenting Author(s)

  • Ivan Y. Luu, BS

    Medical Student
    University of Southern California
    Arcadia, California

    • Co-Author(s)

  • AH

    Alexander T. Hong
  • MM

    Miguel F. Manzur

    Assistant Professor of Clinical Surgery
    University of Southern California
    Los Angeles, California

  • Sukgu M. Han, MD, MS (he/him/his)

    Professor of Surgery and Chief, Division of Vascular Surgery and Endovascular Therapy
    Keck Medical Center of Univerisity of Southern California
    Los Angeles, California

    • Senior Author Discussant(s)

  • Tze-Woei Tan, MBBS

    Associate Professor of Surgery
    University of Southern California
    Los Angeles, California

Objectives: The effects of systemic chemotherapy on vascular surgery outcomes remain poorly characterized. We evaluated whether preoperative chemotherapy is associated with increased morbidity after lower extremity revascularization (LER).

Methods: This retrospective cohort study utilized a large U.S.-based multicenter database and included adults undergoing LER between 2016 and 2024, stratified by endovascular versus open approach. Exposure was defined as the use of a systemic antineoplastic agent within 90 days before surgery. Propensity score-matched analysis was performed 1:1 based on demographics, comorbidities, medication use, laboratory values, neoplasm location, and autoimmune and inflammatory diseases. Outcomes included major adverse cardiovascular events (MACE), major adverse limb events (MALE), repeat revascularization, and surgical site infection (SSI) within 1 year.

Results: Among 164,011 patients who underwent LER (137,943 endovascular; 26,068 open), 2.0% (n = 3,359) received preoperative chemotherapy. After propensity score matching, 6,708 patients were included. Chemotherapy exposure was associated with increased risk of MACE (RR 1.23, 95% CI 1.09-1.38), MALE (RR 1.42, 95% CI 1.22-1.66), repeat revascularization (RR 1.17, 95% CI 1.08-1.27), and SSI (RR 1.21, 95% CI 1.10-1.46) in any LER. Chemotherapy exposure was associated with a more than 2-fold increase in SSI risk among patients who underwent open revascularization (RR 2.44, 95% CI 1.82–3.28), whereas this association was not significant among patients who underwent endovascular revascularization (RR 1.16, 95% CI 0.92–1.47).

Conclusions: Preoperative chemotherapy is associated with increased risks of MACE, MALE, repeat revascularization, and SSI following LER. Open revascularization may carry disproportionately high infectious morbidity in chemotherapy-exposed patients. Risk stratification and procedural selection should consider chemotherapy exposure in preoperative planning.