title: The current position of precuffed expanded polytetrafluoroethylene bypass grafts in peripheral vascular surgery.
abstract: OBJECTIVE
  Long-term results of precuffed expanded polytetrafluoroethylene (ePTFE) grafts used for peripheral bypass surgery are lacking. The aim of this study was to obtain the long-term outcomes of precuffed ePTFE grafts compared with autologous saphenous vein (ASV) grafts used in patients with peripheral arterial disease (PAD).
  
  
  METHODS
  A single-institution retrospective study of precuffed ePTFE and ASV graft performances in patients with PAD was undertaken between January 2004 and December 2012. Five-year primary patency, secondary patency, and limb salvage rates were determined by Kaplan-Meier analyses.
  
  
  RESULTS
  A total of 467 bypass grafts were included in this study (169 precuffed ePTFE grafts and 298 ASV grafts). Secondary patency rates of ePTFE vs ASV at 1 and 5 years, respectively, were as follows: for 134 supragenicular femoropopliteal bypasses, 60% and 27% vs 89% and 85% (P < .05); for 190 infragenicular femoropopliteal bypasses, 40% and 25% vs 86% and 79% (P < .05); and for 84 femorocrural bypasses, 30% and 14% vs 50% and 50% (P < .05). Five-year limb salvage rates of ePTFE vs ASV for supragenicular femoropopliteal bypasses were 82% vs 94% (P = .16); for infragenicular femoropopliteal bypasses, 41% vs 92% (P < .05); and for femorocrural bypasses, 43% vs 64% (P = .06).
  
  
  CONCLUSIONS
  ASV bypasses are still the first-choice conduit in peripheral bypass surgery performed in patients with PAD. Precuffed ePTFE bypasses are acceptable alternatives in the absence of adequate autologous vein.
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands. Electronic address: JvanderSlegt@amphia.nl.
authors.forename: Jasper
authors.initials: J
authors.lastname: van der Slegt
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Stijn L
authors.initials: SL
authors.lastname: Steunenberg
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Jeroen M W
authors.initials: JM
authors.lastname: Donker
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Eelco J
authors.initials: EJ
authors.lastname: Veen
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Gwan H
authors.initials: GH
authors.lastname: Ho
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Hans G W
authors.initials: HG
authors.lastname: de Groot
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Lijckle
authors.initials: L
authors.lastname: van der Laan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors; D058017:Vascular Grafting / Q000295:instrumentation*; D014654:Vascular Patency
chemical_list: D011138:Polytetrafluoroethylene