Experience with heparin-bonded collagen-coated grafts for infrainguinal bypass.
The perfect conduit for infrainguinal reconstructive surgery does not exist. When autologous vein is not available, then a prosthetic graft must be used. The use of a heparin-bonded graft has the theoretical advantage of reducing smooth muscle cell proliferation and thrombus formation, thereby reducing occlusion rates. The application of a collagen layer to the external surface of the graft serves to reduce transfabric haemorrhage. Forty-six patients underwent 47 infrainguinal reconstructions using heparin-bonded collagen-coated Dacron grafts over a 4-year period. Twenty grafts were for disabling claudication and 27 for critical ischaemia. Twenty-two grafts were to the above knee popliteal artery (47%), 10 to the below knee popliteal (21%) and 15 to one of the crural vessels (32%). There was a cumulative patency at 4 years of 69% for the above knee grafts, and 30-month patency of 58% and 45% for the below knee and crural grafts, respectively. There were three deaths over the study period and eight patients required major amputations.
Lambert
A W
AW
University Department of Surgery, Royal United Hospital, Bath, UK.
Fox
A D
AD
Williams
D J
DJ
Horrocks
M
M
Budd
J S
JS
D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation; D002908:Chronic Disease; D020099:Coated Materials, Biocompatible; D003094:Collagen; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery*; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014654:Vascular Patency
D020099:Coated Materials, Biocompatible; D006493:Heparin; D003094:Collagen