PTFE-vein composite grafts for critical limb ischaemia: a valuable alternative to all-autogenous infrageniculate reconstructions.
OBJECTIVE
to analyse the long-term results of primary composite bypass grafts comparing them to PTFE and vein grafts.


METHODS
a retrospective observational study.


METHODS
between 1980 and 1996, 568 primary infrageniculate bypass procedures were performed; a saphenous-vein graft was used in 428 procedures, a PTFE graft in 44 and a composite PTFE-saphenous-vein graft in 96. Thirty-six composite grafts were below the knee and the remaining 60 extended more distally. Twenty-one bypass grafts from the latter group were sequential. Mean follow-up was 45.6 months. Five-year primary and secondary patency and limb salvage rates were compared by life-table analysis.


RESULTS
cumulative 5-year primary patency for composite grafts was 58% and for saphenous-vein grafts 74%, while secondary patency rate was 75% and 82%, respectively (p <0.05). The 5-year limb salvage rate was 80% for composite grafts and 88% for saphenous-vein grafts (p >0.05). The primary and secondary patency and limb salvage rate for PTFE grafts was 24%, 31% and 40%, respectively.


CONCLUSIONS
Composite grafts of PTFE and saphenous vein are significantly superior to PTFE graft alone and should be used in patients who lack sufficient length of saphenous vein.
Bastounis
E
E
First Department of Surgery, University of Athens Medical School, Athens, Greece.
Georgopoulos
S
S
Maltezos
C
C
Alexiou
D
D
Chiotopoulos
D
D
Bramis
J
J
D000368:Aged; D000704:Analysis of Variance; D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D016009:Chi-Square Distribution; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D015993:Life Tables; D008297:Male; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D016909:Tibial Arteries / Q000601:surgery; D016896:Treatment Outcome; D014654:Vascular Patency
D011138:Polytetrafluoroethylene