Polytetrafluoroethylene or saphenous vein as a femoropopliteal bypass graft?

Abstract

This is a retrospective study of 139 consecutive femoropopliteal bypass grafts (64 saphenous vein and 75 polytetrafluoroethylene (PTFE)) performed at one institution from 1972 to 1978 with a maximum of 93 and 63 months follow-up, respectively. Operative indications were intermittent claudication (53.2%), ischemic rest pain (15.1%), and gangrene (31.6%). Associated diseases were heart disease (54.7%), diabetes (36.7%), and hypertension (24.5%). Overall mortality was 2.9%. Patency by life-table analysis is as follows: a Patency (%) Graft 1 month 6 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years Vein 92 84 71 59 49 41 41 30 30 PTFE 93 84 75 51 48 39 31 X a X a a No data. There is no significant difference in overall patency between vein and PTFE ( P > 0.8). Both grafts were compared by similar runoff: poor (isolated popliteal and one vessel—24.5%) and good (two and three vessels—72.7%)—P values were <0.05 and >0.2, respectively. Analysis of patency as compared to operative indications for both grafts were: claudication, P > 0.3; rest pain, P > 0.2; and gangrene, P > 0.2. Patency was then compared to distal anastomotic site—P values were greater than 0.2 between vein and PTFE at either above the knee or below the knee sites. Conclusion: PTFE is comparable to saphenous vein as a femoropopliteal bypass material with the exception of use in poor runoff situations.