Dacron or ePTFE graft for above-knee femoropopliteal bypass reconstruction. A bi-centre randomised study.
BACKGROUND
The objective of this study was to compare polyester (Dacron) and expanded polytetrafluorethilene (ePTFE) grafts for above-knee femoropopliteal bypass.


METHODS
Eighty five patients with disabling claudications or limb threatening ischemia suitable for above-knee femoropopliteal reconstruction were randomized into two groups. In the first group the surgery was performed using 8 mm Dacron graft, whereas the patients in the second group were operated using ePTFE grafts.


RESULTS
The primary patency rates for Dacron and ePTFE were 100 %, and 88.37 % (p < 0.05), while secondary patency rates were 83.3 % and 75 % (p > 0.05) respectively. The early limb salvage rates for Dacron and ePTFE were 100 % and 97.7 % (p > 0.05). Early (30-day) complications (bleeding 2.38 % and 2.32 %; wound infection 11.9 % and 11.63 %) occurred in both groups with similar frequency (p > 0.05). The patients were followed up over a period of 6 to 12 months (mean 8.3 +/- 3.6 months). The overall mortality rate in the follow-up period was 2.38 % (one patient) for Dacron and 6.98 % (three patients) for ePTFE group (p > 0.05). Late graft infection was noted in three patients (7.1 %) in Dacron, and two patients (4.65 %) in ePTFE group (p > 0.05). Primary patency rates were not significantly influenced by obesity, diabetes, hypertension, hyperlipidemia, cigarette smoking, (p > 0.05). However, poor run-off (only one crural artery patent on preoperative angiography) significantly decreased patency of both grafts and favored the use of ePTFE graft (p < 0.05).


CONCLUSIONS
This study confirms that both materials are suitable for above-knee femoropopliteal reconstructions. Above-knee femoropopliteal bypass does not have a good long-term prognosis in the presence of poor run-off.
Davidovic
L
L
Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia.
Jakovljevic
N
N
Radak
D
D
Dragas
M
M
Ilic
N
N
Koncar
I
I
Markovic
D
D
D000368:Aged; D013504:Cardiovascular Surgical Procedures; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005269:Femur / Q000098:blood supply; D006801:Humans; D007719:Knee Joint / Q000098:blood supply / Q000601:surgery; D008297:Male; D011093:Polyethylene Terephthalates / Q000627:therapeutic use*; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D011150:Popliteal Artery / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology
D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene