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Femoropopliteal bypass revisited: an analysis of 138 cases. Cardiovasc Surg 1996 Apr;4(2):195-9

Date

04/01/1996

Pubmed ID

8861436

DOI

10.1016/0967-2109(96)82314-3

Scopus ID

2-s2.0-0029878340   16 Citations

Abstract

Femoropopliteal bypass is utilized for infrainguinal arterial reconstruction in patients with claudication, rest pain, non-healing ulcers and gangrene. Reported patency and limb salvage rates have varied considerably and controversy exists concerning conduit choice. The purpose of this study was to review the authors' results with femoropopliteal bypass to determine factors which may influence outcome in a contemporary series of patients. Between 1986 and 1991, 138 femoropopliteal bypasses were performed in 120 patients. Mean follow-up was 28 (range 1-66) months. Autogenous vein was used in 59% and polytetrafluoroethylene (PTFE) in the remainder. Above-knee anastomoses were performed in 34% and below-knee in 66%. The secondary patency for autogenous vein grafts (95% at 4 years) was significantly better than for PTFE grafts (69% at 4 years; P<0.01). Secondary patency for below-knee autogenous vein grafts also was better than that for below-knee PTFE grafts (95% versus 50% at 4 years; P<0.02). Limb salavage rates were worse for below-knee PTFE grafts than all other groups (P<0.01). Eight of 15 failed above-knee PTFE grafts were salvaged with below-knee autogenous vein grafts and did well. In the present series, autogenous vein femoropopliteal grafts demonstrated better overall patency and limb salvage. Below-knee PTFE bypasses should be reserved for limb salvage cases in patients without adequate autogenous conduits. Failed PTFE grafts can be salvaged by autogenous bypasses, yet an advantage to this approach was not seen.

Author List

Plecha EJ, Freischlag JA, Seabrook GR, Towne JB

Author

Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Blood Vessel Prosthesis
Female
Femoral Artery
Groin
Humans
Leg
Male
Middle Aged
Polytetrafluoroethylene
Popliteal Artery
Retrospective Studies
Treatment Outcome
Vascular Patency
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc