OUTCOME OF POLYTETRAFLUOROETHYLENE VERSUS DACRON GRAFTS FOR SUPRAGENICULAR FEMOROPOPLITEAL ARTERIAL BYPASSES

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Background: Long saphenous vein (LSV) is used usually as the graft of the choice in the treatment of critical limb ischemia (CLI). LSV graft in femoropopliteal and femrodistal bypasses is more durable and also associated with reduced surgical mortality ratios and good success rates in preserving the ischemic limb. Synthetic graft, i.e. Dacron /Polytetrafluoroethylene (PTFE) is a good alternative if the saphenous vein is not available. PTFE has been the most popular choice. However, the preference for PTFE over Dacron is not evidence-based. The optimum graft configuration for the above-knee femoropopliteal bypass, whether PTFE or Dacron, remains a subject of controversy. Objective: To outcome whether Dacron versus PTFE Grafts as optimum in supragenicular femoropopliteal revascularization. Patients and Methods: Fifty patients with critical limb ischemia referred to Vascular Surgery Department, Al-Azhar University, Sednawy and El-Araby Hospitals were included during the period from July 2018 to April 2020. They had foot lesions as ulcer, wound or tissue loss associated with non-palpable distal pulses, and long occlusion of superficial femoral artery (SFA) defined as TransAtlantic Inter-Society Consensus (TASC) II C or D lesions. End points were healed, healing, nonhealing wounds or amputation. Patients were divided into two groups: group A included 25 patients who underwent Dacron graft bypass “DB”, and group B included 25 patients who underwent PTFE bypass “PB”. Results: Twenty- two patients (44%) reached the end point of complete healing (10 patients did “DB” and 12 did “PB”), whereas twenty-six patients (52%) had no or inadequate healing lesions. The limb salvage after one year was 40 patients (80%): 21 of them with ‘DB’ technique, and 19 with ‘PB’ technique. The remaining 8 patients (16%) underwent major amputation (5 with ‘DB’ technique and 3 with ‘PB’ technique) and two patients (4%) died. The early patency rate at 1 and 3 months was 92.43 % in the group with ‘DB’, and 94.39% in the group with ‘PB’. The late patency rate at one year post-operatively was 63.63 % in the ‘DB’ group and 68.63 % in the ‘PB’ group. Conclusion: Both Dacron and PTFE grafts were effective regarding wound healing and limb salvage as well as patency rate in supragenicular femoropopliteal revascularization.