Preferential Use of ePTFE For Above-Knee Femoropopliteal Bypass Grafts

Robert B. Patterson, Richard J. Fowl, Richard F. Kempczinski, Robert Gewirtz, Rakesh Shukla

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

We have used polytetrafluoroethylene preferentially for bypasses to the above-knee popliteal artery since 1979. Since this approach has recently been challenged, we reviewed our experience with 138 grafts in 128 patients. The majority (74%) of patients were male with a mean age of 63.2 years. Risk factors included: smoking (85%), hypertension (55%), diabetes mellitus (45%), and coronary artery disease (41%). The indications for operation were disabling claudication (18%), rest pain (42%), gangrene/tissue loss (33%), and miscellaneous (7%). Perioperative (30 day) mortality was 3% and morbidity (excluding amputation or graft failure) was 5%. Patients were followed for up to eight years with a mean follow-up of 22.1 months. Grafts which remained patent, but did not prevent major amputation, were classified as “failed”. Primary patency was 75% at one year and 54% at five years. Limb salvage was 88% at one year and 70% at five years. Risk factors, indication for operation and arteriographic runoff had no statistically significant impact on short- or long-term patency. However, bypass grafts to isolated popliteal segments had a significantly (p = 0.025) increased perioperative failure rate compared to all other grafts. Our data support the continued use of polytetrafluoroethylene for above-knee femoropopliteal bypass except perhaps in patients who require grafting to an isolated popliteal segment where higher early failure rates were seen.

Original languageEnglish (US)
Pages (from-to)338-343
Number of pages6
JournalAnnals of Vascular Surgery
Volume4
Issue number4
DOIs
StatePublished - 1990

Keywords

  • Extended polytetrafluoroethylene grafts
  • popliteal artery bypass

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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