These data show that the Propaten HePTFE graft offered significantly better long-term patency over the SePTFE graft, suggesting Propaten as the prosthetic graft of choice for bypasses to the femoropopliteal artery when autologous vein is unavailable or inappropriate.
Our data indicate that AxBFB and AxUFB performed with the use of modern protocols and technology may render them an acceptable valid primary intervention in patients in whom endovascular treatment has failed or is unlikely to offer long-term success. The simplicity of performing these grafts and their low mortality and morbidity lend their application to surgeons with limited open aortic experience. Because AxUFB and AxBFB have similar patency rates, AxBFB should be reserved for bilateral indications.
The cohort had an average age of 61.2 years (61% male, 53% Caucasian). The average follow-up time was 3.9 years. A stratified analysis demonstrated the most sensitive cutoff for mortality was aortic diameter >44 mm (P < .0002), and it appeared to be a threshold effect with minimal additional information added by finer size stratification. FL diameter did not predict mortality in our series (P ¼ .4). Intervention-free survival, alternatively, appeared to decrease over the range of diameters from 35 to 44 mm (P < .008). A false lumen diameter >22 mm was associated with decreased intervention-free survival (P < .04). Diameter >44 mm persisted as a risk factor (HR, 8.7; P < .0001) after adjustment for diabetes (6.5; P < .0002), age (1.05/yr; P < .0005), history of stroke (5.6; P < .005), connective tissue disorder (2.3; P < .008) and syncope on admission (9.6; P < .05). The 1-, 5-, and 10-year intervention rate for patients with an admission aortic diameter >44 mm was 12.5%, 18.5%, and 27.7% compared with 4.6%, 13.7%, and 12.2% in the #44 mm group (P < .001).Conclusions: Aortic diameter >44 mm is a predictor of mortality after adjustment for other significant risk factors. A FL diameter >22 mm was associated with decreased intervention-free survival. uATBAD patients with these high-risk criteria should be considered for TEVAR.
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