FemoroPopliteal and FemoroTibial Arterial Bypasses for Limb Salvage

Abstract

Personal experiences with femoropopliteal and tibial artery bypasses to save limbs are reviewed. There were 315 consecutive bypass procedures in 249 patients over a period of 5 years and 6 months. Femoropopliteal bypasses were done with autogenous greater saphenous vein grafts in 102 cases and with PTFE (expanded polytetrafluoroethylene, Gore-Tex) grafts in 100 cases. Femoropopliteal artery bypasses were done with superficial femoral vein grafts in three cases, with bank veins in two cases, and with arm veins in three. In two cases proximal bypasses were made above the inguinal ligament, and these were included in the series of femoropopliteal artery bypasses. There were 70 cases of femorotibial artery bypasses with autogenous greater saphenous vein grafts, two cases with arm veins, and 19 cases with PTFE grafts. In seven cases sequential bypasses were done (femoropoplitealtibial arte rial bypasses) with autogenous greater saphenous vein grafts. In 15 cases popliteal-distal tibial artery bypasses were done with autogenous greater saphenous vein grafts. In 15 cases popliteal-distal tibial artery bypasses were done with autogenous greater saphenous vein grafts. Accumulated patency rates at 5 years were 83% and 68.7% in femoropopli teal and femorotibial artery bypasses with autogenous greater saphenous vein grafts. The accumulated patency rates at 3 years were 83% and 22% in femoropopliteal and femorotibial artery bypasses with PTFE grafts.