Improved patency of infrainguinal polytetrafluoroethylene bypass grafts using a distal Taylor vein patch.
OBJECTIVE
The purpose of this study was to evaluate graft patency and limb salvage rates for infrainguinal polytetrafluoroethylene (PTFE) bypass grafts using distal anastomotic Taylor vein patch in patients lacking suitable vein conduit.


METHODS
We reviewed 44 patients who underwent infrainguinal bypass between January 1996 and August 2000 using 6-mm PTFE and a distal Taylor vein patch. Postoperative oral anticoagulation was administered to 80% of patients. Graft patency was confirmed during follow-up with serial graft duplex scanning.


RESULTS
Operative indications were rest pain, nonhealing ulcer, or gangrene in 76% of patients, 43% of whom had undergone previous ipsilateral leg bypass. Distal anastomotic sites were the below-knee popliteal (29%) and tibial-peroneal arteries (67%). At 1 month, 1 year, and 2 years, respectively, the primary patencies (SE <10%) were 86%, 71%, and 71%; limb salvage rates were 95%, 75%, and 66%; and mortality rates were 5%, 20%, and 20%.


CONCLUSIONS
These early results with PTFE and distal Taylor vein patch are promising, and markedly superior to previous reports of PTFE without anastomotic modification. Further long-term follow-up will be necessary to determine the 3- to 5-year durability of such reconstructions.
Yeung
K K
KK
Department of Surgery, Section of Vascular Surgery, University of Arizona Health Sciences Center, P.O. Box 245072, 1501 N. Campbell Ave., Tucson, AZ 85724-5072, USA.
Mills
J L
JL
Hughes
J D
JD
Berman
S S
SS
Gentile
A T
AT
Westerband
A
A
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D012189:Retrospective Studies; D014654:Vascular Patency; D014680:Veins / Q000601:surgery
D000925:Anticoagulants; D011138:Polytetrafluoroethylene