Distal polytetrafluoroethylene bypasses in patients older than 75 years.
OBJECTIVE
Polytetrafluoroethylene (PTFE) alone is justified for infrapopliteal arterial grafting in elderly patients with critical ischemia of the lower limbs who lack a suitable, autogenous saphenous vein.


METHODS
A consecutive sample clinical study with a mean follow-up of 16 months.


METHODS
The surgical department of an academic tertiary care center and an affiliated secondary care center.


METHODS
Thirty-one patients older than 75 years with critical ischemia of the lower limbs received 34 PTFE bypass grafts to the infrapopliteal arteries: 12 patients to the anterior tibial, 8 to the peroneal, 8 to the posterior tibial, and 2 to the dorsalis pedis artery.


METHODS
Cumulative survival, primary graft patency, and limb salvage rates expressed by standard life-table analysis.


RESULTS
Operative mortality rate was 3%. Cumulative survival rate was 80% at 2 years (SE, 9.2%) and 43% at 3 years (SE, 11.4%). Cumulative primary patency rate was 67% at 2 years (SE 9.1%), and 61% at 3 years (SE, 12.7%). Cumulative limb salvage rate was 77% at 2 years (SE, 8.7%) and 70% at 3 years (SE, 12.8%).


CONCLUSIONS
Polytetrafluoroethylene alone is justified as graft material for infrapopliteal bypass grafts in elderly patients with critical ischemia of the lower limbs and without a suitable autogenous saphenous vein.
Illuminati
G
G
Department of Surgical Sciences and Applied Technologies, University of Rome La Sapienza, Italy.
Bertagni
A
A
Caliò
F G
FG
Papaspyropoulos
V
V
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D016638:Critical Illness; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery; D016909:Tibial Arteries / Q000601:surgery; D013997:Time Factors; D014654:Vascular Patency
D011138:Polytetrafluoroethylene