Femoral-anterior tibial reconstructions using cuffed PTFE grafts: routing alternatives.
BACKGROUND
The anterior tibial is the less often used artery for distal anastomosis in infrapopliteal bypass with synthetic grafts; however, several investigators argue against even an attempt to use non-autologous material for such distal reconstructions. Only few studies report patency rates mixing-up popliteal below-knee and various crural bypasses.


METHODS
Nineteen consecutive femoral-anterior tibial cuffed PTFE bypass grafts, either via the lateral (n = 15) or interosseous (n = 4) route, were inserted in a 10-years period.


RESULTS
The 1-year and 2-year primary patency rate was 71% and 53%, respectively. It is noteworthy that in one patient a graft positioned via the lateral route remained patient for ten years. No complications were observed regarding the routing methods, whatever increased operating time was required in the interosseous route cases. The 3-year cumulative survival rate for this particular group of patients was 32%.


CONCLUSIONS
Our data indicate that femoral-anterior tibial bypasses using cuffed PTFE grafts via the lateral route result in an acceptable medium-term patency. As such patients have a limited life expectancy, these procedures should be performed when an autologous vein is not available, as opposed to primary amputation.
Lazarides
M K
MK
Department of Vascular Surgery, Demokritos University of Thrace, Alexandroupolis, Greece. mlazarid@med.duth.gr
Tzilalis
V D
VD
Georgiadis
G S
GS
Georgopoulos
S E
SE
Arvanitis
D P
DP
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D015996:Survival Rate; D016909:Tibial Arteries / Q000601:surgery*
D011138:Polytetrafluoroethylene