Results of Femoro-Below Knee PTFE Bypass Graft

ABSTRACT

PURPOSE: Saphenous vein allografts are used for femoral-below knee bypass graft purposes in chronic lower limb ischemia. Polytetrafluoroethylene (PTFE) is an acceptable material for bypass graft, when it is difficult to gain a suitable vein for the graft material, such as the great saphenous, small saphenous, or arm vein. However, some controversy exists as to whether PTFE is equivalent to the saphenous vein as bypass graft material for femoral below knee revascularization. A retrospective analysis was performed to obtain results about femoral-below knee bypass graft using PTFE in chronic lower ischemia patients. METHOD: Between July 1992 and June 2002, 56 patients with chronic lower limb ischemia underwent femoral-below knee bypass graft. The results of treatment were analyzed retrospectively by the patients's clinical records. Kaplan-Meier analysis was used to estimate patency rate. RESULT: There were 52 men and 2 women, of mean age 66.6 years. The primary patency rate was 65.6%, 44.9%, 38.0%, and 34.0%, and the secondary patency rate was 85.7%, 72.0%, 72.0%, and 56.1%, after 1, 2, 3, and 5 years, respectively. The limb salvage rate was 78.8% in severe lower limb disease, such as disabling claudication, non-healing ulcer, and gangrene. The major amputation rate was 14.3%. There was no mortality within one month after bypass operation. The primary and secondary rates were not correlated with diabetes, inflow procedure, or severity of lower limb ischemia. CONCLUSION: The overall results of this study show that PTFE grafts have an acceptable patency rate when used for femoral-below knee bypass surgery in patients with chronic lower limb ischemia. This study suggests that early diagnosis of occlusion in graft and adjuvant procedures offers improved patency and limb salvage rate.