title: Management of early and late thrombosis of expanded polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts: favorable prognosis with appropriate reoperation.
abstract: In a series of 175 polytetrafluorethylene (PTFE) femoropopliteal bypasses for limb salvage, nine thrombosed within the first montha after operation and 22 thrombosed from 1 to 23 months after operation. With reoperation (four simple thrombectomies and five graft extensions) all nine early closures are patent 3 to 27 months (mean 16 months) later. Four of the late thromboses did not jeopardize the limb, and viability has persisted 4 to 14 months. Eighteen of the late thromboses placed the limb in jeopardy. Appropriate reoperation after preoperative angiography restored graft patency for 2 to 27 months in 14 of 18 cases. Six grafts were patent more than 1 year after reoperation. The operations performed for late thrombosis were incision and patch angioplasty for intimal hyperplasia (25%), graft extension for distal disease (42%), and simple thrombectomy when no cause of thrombosis was identified (33%). These findings justify an aggressive approach with appropriate reoperations when PTFE femoropopliteal bypasses thrombose in the early or late postoperative period. Important additional limb salvage can thereby be obtained.
mesh_terms: D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D007511:Ischemia / Q000601:surgery; D011138:Polytetrafluoroethylene / Q000009:adverse effects*; D011150:Popliteal Artery / Q000601:surgery*; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*; D013997:Time Factors
chemical_list: D011138:Polytetrafluoroethylene