Abstract
Expanded polytetrafluoroethylene (PTFE) grafts have proven to be an acceptable short-term alternative for femoropopliteal reconstruction in those patients without suitable autologous saphenous vein. One hundred and twenty-seven femoropopliteal arterial bypass operations utilizing PTFE grafts were performed in 105 patients. Seven-year follow-up is now available for 20 grafts, 6-year follow-up for 47 grafts, and 5-year follow-up for 62 grafts. Graft occlusion was determined by angiography, Doppler assessment, loss of previously palpable pulses, or return of symptoms. Thirty nonocclusive graft losses were due to death, infection, aneurysm, amputation, or proximal occlusive disease. Overall cumulative patency rate, according to occlusive criteria alone and calculated by the life-table method, was 74% at 6 months, 63% at 1 year, 48% at 3 years, 40% at 5 years, and 35% at 7 years. Excluding early bypass failures (less than 1 year patency), 75% of grafts were patent at 3 years, 63% at 5 years, and 55% patent 7 years following operation. Diabetes mellitus was associated with a significantly lower patency rate. Patency rates were not adversely affected by graft diameter, distal popliteal anastomotic site, number of patent runoff vessels, preoperative symptoms, or prior arterial reconstruction. In patients without suitable autologous saphenous vein, the PTFE graft has proven to be a durable and dependable long-term alternative for femoropopliteal reconstruction.
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Selected References
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- Campbell C. D., Brooks D. H., Webster M. W., Bondi R. P., Lloyd J. C., Hynes M. F., Bahnson H. T. Aneurysm formation in expanded polytetrafluoroethylene prostheses. Surgery. 1976 May;79(5):491–493. [PubMed] [Google Scholar]
- Campbell C. D., Brooks D. H., Webster M. W., Diamond D. L., Peel R. L., Bahnson H. T. Expanded microporous polytetrafluoroethylene as a vascular substitute: a two year follow-up. Surgery. 1979 Feb;85(2):177–183. [PubMed] [Google Scholar]
- Codd J. E., Barner H. B., Kaminski D. L., Ramey A., Garvin P. J., Kaiser G. C., Willman V. L. Extremity revascularization: a decade of experience. Am J Surg. 1979 Dec;138(6):770–776. doi: 10.1016/0002-9610(79)90294-0. [DOI] [PubMed] [Google Scholar]
- Evans L. E., Webster M. W., Brooks D. H., Bahnson H. T. Expanded polytetrafluoroethylene femoropopliteal grafts: forty-eight-month follow-up. Surgery. 1981 Jan;89(1):16–22. [PubMed] [Google Scholar]
- Haimov H., Giron F., Jacobson J. H., 2nd The expanded polytetrafluoroethylene graft. Three years' experience with 362 grafts. Arch Surg. 1979 Jun;114(6):673–677. doi: 10.1001/archsurg.1979.01370300027003. [DOI] [PubMed] [Google Scholar]
- Hallett J. W., Jr, Brewster D. C., Darling R. C. The limitations of polytetrafluoroethylene in the reconstruction of femoropopliteal and tibial arteries. Surg Gynecol Obstet. 1981 Jun;152(6):819–821. [PubMed] [Google Scholar]
- Hobson R. W., 2nd, O'Donnell J. A., Jamil Z., Mehta K. Below-knee bypass for limb salvage. Comparison of autogenous saphenous vein, polytetrafluoroethylene, and composite dacron-autogenous vein grafts. Arch Surg. 1980 Jul;115(7):833–837. doi: 10.1001/archsurg.1980.01380070023005. [DOI] [PubMed] [Google Scholar]
- Simone S. T., Jr, Dubner B., Safi A. R., DelGuercio P., Shah M. A., Zagorin L., Reichle F. A. Comparative review of early and intermediate patency rates of polytetrafluoroethylene and autogenous saphenous vein grafts for lower extremity ischemia. Surgery. 1981 Dec;90(6):991–999. [PubMed] [Google Scholar]
- Stipa S., Wheelock F. C., Jr A comparison of femoral artery grafts in diabetic and nondiabetic patients. Am J Surg. 1971 Mar;121(3):223–228. doi: 10.1016/0002-9610(71)90194-2. [DOI] [PubMed] [Google Scholar]
- Szilagyi D. E., Hageman J. H., Smith R. F., Elliott J. P., Brown F., Dietz P. Autogenous vein grafting in femoropopliteal atherosclerosis: the limits of its effectiveness. Surgery. 1979 Dec;86(6):836–851. [PubMed] [Google Scholar]
- Veith F. J., Gupta S., Daly V. Management of early and late thrombosis of expanded polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts: favorable prognosis with appropriate reoperation. Surgery. 1980 May;87(5):581–587. [PubMed] [Google Scholar]
- Yeager R. A., Hobson R. W., 2nd, Jamil Z., Lynch T. G., Lee B. C., Jain K. Differential patency and limb salvage for polytetrafluoroethylene and autogenous saphenous vein in severe lower extremity ischemia. Surgery. 1982 Jan;91(1):99–103. [PubMed] [Google Scholar]
