Infrainguinal polytetrafluoroethylene grafts: saved limbs or wasted effort? A report on ten years' experience.
Two-hundred and twenty-four infrainguinal polytetrafluoroethylene reconstructions were performed for critical ischemia over a 10 year period: 48 to the above-knee popliteal artery, 113 to the below-knee popliteal artery, and 63 to the tibial vessels. The cumulative patency rates were 84 +/- 6% and 63 +/- 9% for above-knee popliteal, 53 +/- 5% and 35 +/- 7% for below-knee popliteal, 45 +/- 6% and 30 +/- 9% for tibial vessels at one and five years respectively. Limb salvage rates were 81 +/- 6% and 73 +/- 9% (above-knee popliteal), 69 +/- 5% and 57 +/- 9% (below-knee popliteal), 64 +/- 7% and 32 +/- 10% (tibial vessels) at one and five years respectively. Graft occlusion did not result in limb loss in 32 cases. Preoperatively, 54% of the patients had limited mobility while 43% were regarded as severely restricted. At follow-up, 57% of the patients were considered to be independent, 26% had limited mobility, and 17% were still severely restricted. Polytetrafluoroethylene provides good short-term limb salvage and improved mobility in patients with critical ischemia and poor life expectancy. Its use is well worth the effort.
Davies
M G
MG
Department of Vascular Surgery, St. James' Hospital, Dublin, Ireland.
Feeley
T M
TM
O'Malley
M K
MK
Colgan
M P
MP
Moore
D J
DJ
Shanik
G D
GD
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006119:Groin; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D007717:Knee / Q000098:blood supply; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D015996:Survival Rate; D013927:Thrombosis / Q000601:surgery; D016909:Tibial Arteries / Q000601:surgery; D014463:Ultrasonography; D014654:Vascular Patency
D011138:Polytetrafluoroethylene