PAD and Bypass Surgery: Scoping Review with ☸️SAIMSARA

This paper aims to systematically synthesize the current evidence on bypass surgery for peripheral artery disease, focusing on key outcomes, prognostic factors, and comparisons with alternative treatment modalities, as extracted from a structured summary of scientific literature. The review utilises 144 original studies with 663925 total participants (topic deduplicated ΣN). This scoping review indicates that outcomes after PAD bypass surgery are strongly patterned by baseline patient risk, with chronic kidney disease and especially hemodialysis status emerging as a prominent signal for worse survival and major adverse events across the evidence map. Across procedural domains, the literature consistently supports a role for careful treatment selection between bypass and endovascular approaches, with bypass often associated with durable patency in complex disease while endovascular strategies may reduce short-term resource use but can require more reinterventions in some settings. Conduit choice and post-operative management recur as practical determinants of success, with autologous vein preference, optimized antithrombotic/medical therapy, and structured surveillance and rehabilitation repeatedly linked to better limb and graft-related trajectories. Interpretation is limited by the scoping, LLM-assisted, and non–risk-of-bias–appraised nature of the workflow, which prioritizes evidence mapping over causal estimation. Clinically, the findings highlight the need for intensified preoperative risk stratification and longitudinal follow-up in high-risk groups, while research should focus on phenotype-specific comparative effectiveness studies that align technique, conduit, and medical therapy to patient risk profiles.