Above-knee femoropopliteal bypass grafts and the consequences of graft failure.
In all, 290 femoral to above-knee popliteal artery bypasses were performed between January 1983 and September 1991. PTFE grafts were used in 113 cases (39%) and vein grafts in 177 (61%) (reversed in 146 cases and in situ in 31). Patients were followed up for a median time of 20 months. The 2-, 4- and 6-year patency rates for vein and PTFE grafts were 70%, 62% and 57%, respectively, compared with 58%, 46% and 41% (no statistical difference in survival curves, P = 0.2). The 2-, 4- and 6-year limb salvage rates were 82%, 78% and 62% compared with 75%, 64% and 58% (no statistical difference in survival curves, P = 0.6). A total of 99 grafts occluded during follow-up (45 PTFE and 54 vein grafts). Major amputation was required in 63 limbs; below-knee in 37 limbs (59%), and above-knee in 26 limbs (41%). There was no statistical difference in the amputation level with respect to the graft type. Final healing at the below-knee level was achieved in 23 of 35 (66%) failed vein grafts and in 14 of 28 (50%) failed PTFE grafts.
John
T G
TG
Department of Surgery, Royal Infirmary, Edinburgh.
Stonebridge
P A
PA
Kelman
J
J
Murie
J A
JA
Jenkins
A M
AM
Ruckley
C V
CV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D012501:Saphenous Vein / Q000637:transplantation
D011138:Polytetrafluoroethylene