Dacron vs. polytetrafluoroethylene grafts for femoropopliteal bypass: a prospective randomised multicentre trial.
OBJECTIVE
To compare the patency of PTFE (Polytetrafluoroethylene) and unsealed knitted Dacron femoro-popliteal bypasses.


METHODS
Multi-centre prospective randomised trial.


METHODS
Of 203 patients randomised, 194 were included in the final analysis (103 Dacron grafts and 91 PTFE grafts). The median follow-up was 36 months (range: 6-72 months); the distal anastomosis was above-knee in 141 and below-knee in 53 cases. Univariate comparisons of patency were made by the Kaplan-Meier method, multivariate calculations on the effects of covariables by a Cox regression analysis.


RESULTS
There was no difference regarding primary and secondary patency or limb salvage between Dacron and PTFE. The primary 3-year patency for Dacron grafts was 64% (95% confidence interval [C.I.] 55-74%) and for PTFE grafts 61% (C.I. 49-72%). The corresponding 3-year secondary patency was 81% (C.I. 73-89%) and 75% (C.I. 65-86%) respectively, the limb salvage rate 90% (C.I. 84-96%) and 91% (C.I. 84-97%). Upon multivariate analysis below-knee anastomosis was the principal independent predictor of primary graft failure (risk ratio 1.7 [C.I. 1.05-2.8]), impaired secondary patency was associated with infragenicular bypass (risk ratio 3.3 [C.I. 1.8-6.3]) and distal gangrene (risk ratio [C.I. 1.01-3.8]p=0.048), major amputation was independently predicted by below-knee bypass, tissue necrosis, and poor run-off index.


CONCLUSIONS
PTFE and Dacron are equally suitable for femoro-popliteal bypass.
Post
S
S
Department of Surgery, Universitätsklinikum Mannheim, Mannheim, Germany.
Kraus
T
T
Müller-Reinartz
U
U
Weiss
C
C
Kortmann
H
H
Quentmeier
A
A
Winkler
M
M
Husfeldt
K J
KJ
Allenberg
J R
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000601:surgery*; D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency
D001672:Biocompatible Materials; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene