Femoro-distal bypass for critical ischemia: is the use of prosthetic grafts justified?
The results of 240 femoro-distal bypass operations for critical ischemia have been reviewed. Autologous saphenous vein was the graft material in 112 cases (46.7%) and prosthetic grafts were used in the other 128 cases (53.3%). A distal arteriovenous shunt (AVS) was employed as an adjunct to 72 grafts (30%). The cumulative patency rate at 4 years was 53% for all of the grafts together and the cumulative limb salvage rate was 70%. When autologous saphenous vein was available the actual patency rate at one year after operation was 70% for popliteal grafts and 53% for tibial grafts. In the case of prosthetic grafts the equivalent patency rates were 51% and 35%. In view of the poor success rate of prosthetic grafts anastomosed to distal tibial vessels these procedures are of doubtful value in routine clinical practice.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation; D014471:Umbilical Veins / Q000637:transplantation; D014654:Vascular Patency