Five-Year Patency Rates for Heparin-Bonded Expanded Polytetrafluoroethylene Femoropopliteal Bypass Grafts vs ePTFE Grafts Without Heparin

Abstract

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.

Heparin-bonded expanded polytetrafluoroethylene femoropopliteal bypass grafts outperform expanded polytetrafluoroethylene grafts without heparin in a long-term comparison

“…We performed a retrospective evaluation of all patients who underwent femoropopliteal bypass with one of two SePTFE graft brands with different poresize configurations and similar rates of patency (Atrium Medical Corporation, Nashua, NH; or W. L. Gore & Associates, Flagstaff, Ariz) between 2001 and August 2007. 16 This experience was then compared with a prospective evaluation all patients who later received the HePTFE graft (Propaten; W. L. Gore) graft. The main outcome measure was primary graft patency.…”

Electrospun polyurethane-based vascular grafts: physicochemical properties and functioning in vivo

“…open surgery is required. The replacement of such vessels in the current surgical practice utilizes autologous vessels (veins or arteries) [4], decellularized vascular grafts (VGs) [5], or synthetic VGs manufactured from expanded polytetrafluoroethylene (e-PTFE) [6] or polyethylene terephthalate (Dacron) [7]. Note that autologous vessels are not always available, whereas decellularized xenogenic VGs are prone to aneurismal degradation in the long term [8].…”

Heparin/Collagen-REDV Modification of Expanded Polytetrafluoroethylene Improves Regional Anti-thrombosis and Reduces Foreign Body Reactions in Local Tissues

“…Surface modification can be used not only to change physical properties, but also to provide regional anticoagulant therapy via coating surface materials with anticoagulant drugs ( Hoshi et al, 2013 ). Indeed, ePTFE modified with heparin has been proven efficacious for clinical use ( Samson et al, 2016 ; Shibutani et al, 2020 ). The collagen combined with heparin was designed to further stabilize the modification system, improving its anticoagulation ability, cytocompatibility and mechanical properties ( Driessen et al, 2003 ; Ferreira et al, 2016 ).…”