title: Randomized clinical trial of distal anastomotic interposition vein cuff in infrainguinal polytetrafluoroethylene bypass grafting.
abstract: BACKGROUND
  The aim was to examine the effect of a Miller vein cuff at the distal anastomosis on the medium- to long-term patency and limb salvage rates of femoral to above-knee and femoral to below-knee popliteal artery polytetrafluoroethylene (PTFE) bypasses.
  
  
  METHODS
  This study involved extended follow-up of the original cohort of patients included in a previously reported multicentre randomized clinical study. Outcome measures were bypass graft patency and limb salvage.
  
  
  RESULTS
  Two hundred and sixty-one bypass operations were originally randomized. For this study, full data were available on 235 (120 with a Miller cuff, 115 without). The cumulative 5-year patency rate for above-knee bypasses with a Miller cuff was 40 per cent, compared with 42 per cent for non-cuffed bypasses (P = 0.702). The cumulative 3-year patency rate for below-knee bypasses with a Miller cuff was 45 per cent, compared with 19 per cent for non-cuffed bypasses (P = 0.018). A Miller cuff had no significant effect on limb salvage for above-knee or below-knee bypasses.
  
  
  CONCLUSIONS
  Three-year patency rates of femoral to below-knee popliteal PTFE bypasses were improved by a Miller cuff. Miller cuffs had no effect on patency rates for femoral to above-knee popliteal bypasses at 5 years and did not improve limb salvage in either group.
authors.affiliation: Department of Vascular Surgery, Ninewells Hospital, Dundee DD1 9SY, UK. gareth.d.griffiths@tuht.scot.nhs.uk
authors.forename: G D
authors.initials: GD
authors.lastname: Griffiths
authors.forename: J
authors.initials: J
authors.lastname: Nagy
authors.forename: D
authors.initials: D
authors.lastname: Black
authors.forename: P A
authors.initials: PA
authors.lastname: Stonebridge
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D011150:Popliteal Artery / Q000601:surgery*; D014654:Vascular Patency
chemical_list: D011138:Polytetrafluoroethylene