Popliteal Angioplasty as an Adjunct to Above-the-Knee Synthetic Femoropopliteal Bypass: Comparison of Long-Term Results with Below-the-Knee Bypass

Abstract

Long-term results of 27 above-the-knee (AK) synthetic femoropopliteal (SYN-FP) bypasses with simultaneous intraoperative popliteal angioplasty (Group A) were reviewed and compared with 23 below-the-knee (BK) SYN-FP bypasses performed during the same time interval (Group B). Twenty-six of the 27 (96%) popliteal arteries were angioplastied successfully. One patient died postoperatively. Twenty-five limbs had no early occlusions (<30 days), and the postoperative ankle:brachial ratio increased from 0.40 to 0.81 (p < 0.01). The one-year primary patency, secondary patency, and limb salvage rates were 69%, 82%, and 95% in Group A, and 66%, 66%, and 81% in Group B, respectively (p < 0.05). Intraoperative popliteal angioplasty as an adjunct to femoropopliteal bypass was effective. Five-year primary patency, secondary patency, and limb-salvage rates for Group A were 51%, 58%, and 76%, and 34%, 46%, and 59% for Group B, respectively. The mortality rate at five years was 59% (16/27) for Group A and 65% (15/23) for Group B.