Occlusion of femoropopliteal bypasses (Biografts).
In a series of 225 femoropopliteal bypasses with a Biograft (1978-1983) there were 57 failures due to occlusion of the graft. The main cause was progressive atherosclerotic disease. Inflow obstruction occurred 12 times and outflow obstruction 27 times. Biograft-related causes were kinking of the graft in 7 and distal anastomotic stenosis in 11 cases. Forty nine of the 57 failures were submitted to reoperation. Inflow obstructions were corrected easily. Outflow obstructions were corrected with a jump graft in most of the above-knee cases. Outflow obstructions in the below-knee cases were difficult to correct. Thrombectomy and endarterectomy were successful on a few occasions. After occlusion of the Biograft due to kinking, a simple thrombectomy was always sufficient. Stenosis of the distal anastomosis made a patch angioplasty necessary. The 49 reoperations were initially successful in 38 patients (77%). Major amputation of the leg after an unsuccessful reintervention was necessary in 5 cases.
D001161:Arteriosclerosis / Q000150:complications* / Q000628:therapy; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D004691:Endarterectomy; D005263:Femoral Artery / Q000601:surgery*; D005734:Gangrene / Q000517:prevention & control; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007383:Intermittent Claudication / Q000628:therapy; D011150:Popliteal Artery / Q000601:surgery*