Midterm results of autologous saphenous vein and ePTFE pre-cuffed bypass surgery in peripheral arterial occlusive disease.
Vasc Endovascular Surg
; 45(7): 598-603, 2011 Oct.
Article
in En
| MEDLINE
| ID: mdl-21757494
ABSTRACT
INTRODUCTION:
The graft of choice in lower limb bypass surgery is the autologous saphenous vein (ASV). However, a prosthetic graft is needed in the absence of an ASV. In such situations, we used an expanded polytetrafluoroethylene (ePTFE) pre-cuffed Dynaflo graft as supragenicular bypass or Distaflo graft as infragenicular or femorocrural bypass. In respect to the expanding possibilities of percutaneous transluminal angioplasty (PTA), the indication for bypass surgery moved toward patients with advanced stages of peripheral arterial occlusive disease. For this reason, this study analyzed the current performances of these ePTFE grafts and ASV grafts with special attention to limb salvage.METHODS:
In a retrospective study all patients who underwent peripheral bypass surgery between 2004 and 2008 were included. Kaplan-Meier curves were used to express primary patency, secondary patency, and limb salvage rates at 1 and 3 years. Log-rank tests were performed to compare graft types.RESULTS:
A total of 272 grafts (ePTFE/ASV 110/162) were performed in lower limb bypass surgery. The mean follow-up was 20.3 months. The secondary 3-year patency rates were for (n=78) supragenicular grafts (ePTFE/ASV 45%/94%)*, for (n=124) infragenicular grafts (24%/74%), and 70 for femorocrural grafts (26%/52%). Limb salvage after 3 years was 59% in the ePTFE group versus 78% in the ASV group (P < .05).CONCLUSION:
In the current population of vascular patients where no PTA is possible and a peripheral bypass is necessary, the ASV remains the graft of first choice. However, the pre-cuffed ePTFE graft is a good alternative, especially in cases of critical limb ischemia, in respect to an acceptable limb salvage rate.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Polytetrafluoroethylene
/
Popliteal Artery
/
Arterial Occlusive Diseases
/
Saphenous Vein
/
Blood Vessel Prosthesis
/
Blood Vessel Prosthesis Implantation
/
Lower Extremity
/
Femoral Artery
Type of study:
Etiology_studies
/
Observational_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Vasc Endovascular Surg
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2011
Document type:
Article
Affiliation country:
Netherlands