Polytetrafluoroethylene (PTFE) femorodistal grafts with a distal vein cuff for critical ischaemia.
OBJECTIVE
To analyse the results of PTFE femorodistal bypass grafts using a distal anastomotic vein cuff in the treatment of critical ischaemia.


METHODS
Prospective study of consecutive patients under the care of a single Vascular Surgeon.


METHODS
A dedicated Vascular Surgical Unit in a University teaching hospital.


METHODS
Fifty-one consecutive femorodistal PTFE grafts were performed on 50 patients (median 74 years, range 58-94 years, 25 men; median ankle:brachial index 0.4). In 28 (55%) a common ostium arteriovenous fistula (AVF) was fashioned at the distal anastomosis.


RESULTS
The 30-day postoperative mortality was 8%, with 10 (21%) major complications. The 1 and 2 year primary patency was 64% and 51%, respectively, with corresponding limb salvage rates of 85% and 80%. The presence of an AVF did not significantly affect graft patency or patient survival, but appeared to hinder limb salvage. The latter effect may be due to bias in patient selection.


CONCLUSIONS
PTFE femorodistal grafts with a distal vein cuff are a suitable alternative to autogenous saphenous vein in distal reconstructions for critical ischaemia. No conclusions can be made about the efficacy of an AVF in this context.
Wijesinghe
L D
LD
Department of Vascular and Endovascular Surgery, St James's University Hospital, Leeds, U.K.
Beardsmore
D M
DM
Scott
D J
DJ
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000714:Anastomosis, Surgical; D000842:Ankle / Q000098:blood supply; D001166:Arteriovenous Shunt, Surgical; D015982:Bias; D001794:Blood Pressure; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D001916:Brachial Artery / Q000502:physiology; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D015996:Survival Rate; D014654:Vascular Patency; D014680:Veins / Q000637:transplantation
D011138:Polytetrafluoroethylene