Prospective controlled study of polytetrafluoroethylene versus saphenous vein in claudicant patients with bilateral above knee femoropopliteal bypasses

Abstract

PTFE and SVG for above knee bypasses have comparable patency and limb salvage rates in claudicant patients with bilateral superficial femoral artery occlusion and 2- to 3-vessel runoff This may justify the use of PTFE for above knee locations in these selected patients.

Cuffed anastomosis for above-knee femoropopliteal bypass with a stretch expanded polytetrafluoroethylene graft

“…3,6,11,12 Two of these studies included only patients with claudication. 2,4 On the other hand, two randomized controlled trials showed no difference in patency for up to 2 years, 15 but SV was signifi cantly better thereafter. 2,4,7 Recent data from the Swedish vascular registry showed that CLI and ePTFE bypass grafting are risk factors for graft failure.…”

“…2,4 On the other hand, two randomized controlled trials showed no difference in patency for up to 2 years, 15 but SV was signifi cantly better thereafter. 2,4,7 Recent data from the Swedish vascular registry showed that CLI and ePTFE bypass grafting are risk factors for graft failure. 8 The report based on these data concluded that above-knee FP bypasses using SV provide good longterm results and that ePTFE grafts are not appropriate for patients with claudication because occlusion developed in about one third of patients who underwent surgery for this condition and 41% suffered worse symptoms than they had preoperatively.…”

“…However, none of the eight trials that compared vein grafts with ePTFE prostheses found that concomitant diabetes affected patency. [2][3][4][11][12][13][14][15] Two studies showed similar 5-year patency rates for vein and ePTFE grafts in patients with diabetes: 39% 2 (98% smokers) and 54%, 16 (85% smokers), respectively. Only Prendiville et al 17 reported that cigarette smoking and diabetes affected the patency of revascularizations using ePTFE.…”

“…3 Several more recent studies suggest that autogenous SV grafts have better patency than ePTFE grafts in above-knee FP bypasses, with 2-year patency rates for prosthetic grafts ranging from 56% to 69%. [3][4][5][6][7] An investigation based on data from the Swedish vascular registry concluded that ePTFE grafts are not recommended for patients with claudication, based on the fi nding that occlusion developed in about one-third of patients who underwent surgery for this condition. 8 A collective review found that the 2-and 5-year primary patency rates for 5-to 8-mm ePTFE grafts are about 67% and 49%, respectively, even if the distal anastomosis is in the above-knee segment of the popliteal artery.…”

Kritische Extremitätenischämie

“…Alternativ kön-nen die Vena saphena parva, die Armvenen sowie die Vena femoralis superficialis implantiert werden. Deutlich schlechtere Ergebnisse werden mit Kunststoffbypässen erzielt[1]. Im kruralen Bereich liegt die 5-Jahres-Offenheitsrate mit autologer Vene bei 60%, die der Kunststoffbypässe <35%[27].…”