Below-knee bypass for limb salvage. Comparison of autogenous saphenous vein, polytetrafluoroethylene, and composite dacron-autogenous vein grafts.
Autogenous saphenous vein was used preferentially for 92 below-knee bypass procedures (44 femoral-distal popliteal and 48 femoral-distal tibial or peroneal) performed for limb salvage in 87 adult male patients during a 30-month period of study. When a saphenous vein was unavailable or of unsuitable length or diameter, we randomly used expanded polytetrafluoroethylene (PTFE) and composite Dacron-autogenous vein (DV) grafts. With good run-off, all grafts have remained patent. However, with poor run-off, cumulative patency by the life table method decreased to 54% for autogenous saphenous vein and 45% for PTFE, which was not significantly different. All composite DV grafts used with poor run-off became occluded within the first ten months of the study. We continue to recommend use of autogenous saphenous vein for revascularization of the ischemic lower extremity. When a suitable saphenous vein is unavailable, PTFE is a satisfactory alternative graft that is superior to composite DV grafts.
D000368:Aged; D000671:Amputation, Surgical; D000792:Angiography; D001807:Blood Vessel Prosthesis; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery; D011183:Postoperative Complications; D012501:Saphenous Vein / Q000637:transplantation; D014182:Transplantation, Autologous; D014656:Vascular Surgical Procedures / Q000401:mortality
D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene