title: Long-term follow-up of endoluminal grafting for aneurysmal and occlusive disease in the superficial femoral artery.
abstract: OBJECTIVE
  To examine the long-term outcome of patients treated with endoluminal grafts (ELGs) for aneurysmal and occlusive disease in the femoropopliteal (FP) segment.
  
  
  METHODS
  ELGs of radially expandable polytetrafluoroethylene with terminal Palmaz stents were used to form intimal conduits to revascularize lengthy occlusive disease and exclude aneurysms in the FP segment. Patient records were reviewed retrospectively for outcome.
  
  
  RESULTS
  Fifty-five (98%) of 56 ELGs were placed successfully in 51 patients treated from August 1993 to February 1996. Over a mean 36-month follow-up, 28 (50%) ELGs occluded. Half of these failures reflected early technical difficulties. There were 11 (20%) stent stenoses, 6 in the proximal stent and 5 in the distal device. The majority of the graft failures were treated with endovascular techniques; however, FP bypass was required in 7 (25%) patients, while 2 (7%) were not treated. Life-table analysis demonstrated 46% primary and 68% secondary patency rates at 24 months. Among demographic and procedural variables, only previous dilation or stent procedures in the target artery was associated with failure (p < 0.0001).
  
  
  CONCLUSIONS
  The prototype ELG used in this series demonstrated durability similar to conventional surgical therapy utilizing synthetic material. Endoluminal grafting of FP lesions may be a more durable alternative to classical bypass once devices and techniques are refined.
authors.affiliation: Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Arizona Heart Hospital, Phoenix 85006, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Rodriguez-Lopez
authors.forename: L
authors.initials: L
authors.lastname: Soler
authors.forename: A
authors.initials: A
authors.lastname: Werner
authors.forename: E
authors.initials: E
authors.lastname: Martinez
authors.forename: K
authors.initials: K
authors.lastname: Papazoglou
authors.forename: E B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001672:Biocompatible Materials; D001783:Blood Flow Velocity; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene