b'Scientific Session Abstracts SUNDAY APRIL 21, 2024 Conclusions: The obesity paradox is evident in patients undergoing lower extremity bypass procedures, particularly with reduction in 30-day mortality and MI. Our findings suggest that having higher BMI should not be interpreted as a contraindication for IIB. However, these patients should be under vigilant surveillance for SSI and preventative measures should be implemented. Finally, patients that are underweight have a significantly increased odds of 30- day mortality and may be more suitable candidates for endovascular therapy.Table I: Demographic characteristics by BMI class of 60,588 patientsundergoing lower extremity arterial bypass surgery (2003-2020).BMI 18.518.5BMI 24.9BMI25 Demographics (Underweight) (Non-obese) (Overweight/ p-valueObese)Population size (%) 2540 (4.2) 19118 (31.6) 38930 (64.2) -Age, median (SD) 68.9 (11.1) 68.7 (11.2) 65.8 (10.8) 0.01Sex (Female) 1160 (45.7) 6079 (31.8) 11437 (29.4) 0.01RaceWhite 1918 (75.5) 15118 (79.1) 31700 (81.4)Black 519 (20.4) 3013 (15.8) 5604 (14.4)Asian 22 (0.9) 167 (0.9) 166 (0.4)0.01American Indian 2 (0.1) 52 (0.3) 115 (0.3)Pacific Islander 0 (0.0) 26 (0.1) 38 (0.1)More than 1 race 3 (0.1) 37 (0.2) 71 (0.2)Other 75 (3.0) 700 (3.7) 1228 (3.2)HypertensionNo 409 (16.1) 2784 (14.6) 3957 (10.2)Yes 1934 (76.3) 14946 (78.3) 32073 (82.6) 0.01Yes, Controlled 142 (5.6) 1038 (5.4) 2189 (5.6)Yes, Uncontrolled 50 (2.0) 315 (1.7) 609 (1.6)CADNone 1910 (75.3) 13531 (70.9) 26079 (67.1)Stable Angina 147 (5.8) 1196 (6.3) 2788 (7.2) 0.01Unstable Angina 9 (0.4) 80 (0.4) 223 (0.6)MI within last 634 (1.3) 229 (1.2) 397 (1.0)months42 NDANNUAL MEETING|APRIL 1921, 2024|OCEANSIDE, CA 103'