title: Polytetrafluoroethylene femorotibial bypass grafting: 5-year patency and limb salvage.
abstract: For a femorotibial bypass graft the material of choice is autologous vein. The question remains whether prosthetic material is a reasonable alternative for limb salvage, if autologous vein is not available. From 1991 to 1998, 83 consecutive femorotibial bypass procedures were performed in 70 patients. Thin-walled, ringed 6-mm polytetrafluoroethylene (PTFE) was used, as autologous vein was not available. The indication for the femorotibial bypass was critical ischemia due to atherosclerotic occlusive disease in all cases. Three patients died in the hospital or within 30 days of the operation, resulting in a perioperative mortality rate of 3.6%. After 5 years, 33 patients had died (40%) and 3 patients were lost to follow-up (3.6%). Primary patency was 64.2% after 6 weeks and 18% +/- 5% after 5 years. Secondary patency was 74.1% after 6 weeks and 22.3% +/- 6% after 5 years. When we compared primary and secondary patency for distal anastomosis, there was no difference between the three crural arteries. The limb salvage rate was 61.9% +/- 7% after 5 years. From these results we conclude that, with a limb salvage of 61.9%, PTFE is an acceptable alternative for a femorotibial bypass graft in patients with critical ischemia, if autologous vein is not available.
authors.affiliation: Department of Vascular Surgery, Red Cross Hospital, The Hague, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Klinkert
authors.forename: P J E
authors.initials: PJ
authors.lastname: van Dijk
authors.forename: P J
authors.initials: PJ
authors.lastname: Breslau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D016019:Survival Analysis; D016909:Tibial Arteries / Q000601:surgery; D014654:Vascular Patency
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene