Outcome of the above knee femoro-popliteal prosthetic bypasses in patients with chronic lower limb ischaemia

ABSTRACT

This retrospective study was designed on 20 patients [16 men and 4 women] with critical chronic lower limb ischaemia to ascertain the effectiveness of the polytetrafluoroethylene prosthetic grafts [PTFE grafts] as regard to predictors of success or failure as well as long term patency in patients who underwent above-knee femoropopliteal bypasses during the last 5-years. The study was conducted on 24 limbs in 20 patients. The indication for operation was critical limb ischaemia in 85% of cases and incapacitating claudication in 15% of them. The patients were evaluated clinically, haemodynamically and by imaging techniques. The postoperative follow-up was based on repeated investigations at 1, 3, 6, 9, 12 and 24 months after operation. The 2-, 4 - and 5- year patency rates were 59%, 45% and 40%, while the 2-, 4- and 5- year limb salvage rates were 74%, 63% and 57%. Major amputation was required in 6 limbs [25%]; below-knee in 4 limbs [67%] and above-knee in 2 limbs [33%]. The outcome of above-knee femoropopliteal PTFE bypass grafts was essentially affected by presence of diabetes, poor distal run off, diminished outflow rate as well as multiplicity of the lesions and the severity of each