Usefulness of PTFE Graft in Above-Knee Femoropopliteal Artery Bypass

Byung Jun So; Seung Jae Byun

doi:10.4174/jkss.2009.77.6.410

Journal List > J Korean Surg Soc > v.77(6) > 1011044

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So and Byun: Usefulness of PTFE Graft in Above-Knee Femoropopliteal Artery Bypass

Original Article

Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 77(6): 410-416.

Published online: 4 December 2009

DOI: https://doi.org/10.4174/jkss.2009.77.6.410

Usefulness of PTFE Graft in Above-Knee Femoropopliteal Artery Bypass

Byung Jun So, M.D., Seung Jae Byun, M.D.

Department of Surgery, School of Medicine, Wonkwang University, Iksan, Korea.

Corresponding author (polarisking@hanmail.net)

Received 13 July 2009 Accepted 7 October 2009

Abstract

Purpose

Which graft material is appropriate for the above-knee femoropopliteal (AK fem-pop) bypass has been a controversy. We were to evaluate the usefulness of PTFE graft in AK fem-pop bypass by comparing the results of autogenous vein graft in below-knee femoropopliteal bypass.

Methods

This was a retrospective study of data for Fem-Pop bypass from August 1999 to August 2008. The median follow-up was 59.9±27.3 months. The demographic data, patency rate, secondary procedures, and amputation rate were compared, and statistical comparison was performed by Kaplan-Meier method, Log-rank test, and Chi-square test.

Results

Seventy-three bypasses were performed in 63 patients: PTFE graft in 48 cases (Group A), autogenous vein in 25 cases (Group B). Sixty-one patients (96.81%) were men. The mean age was 67.3±8.0 years. The indication for surgery was intermittent claudication in 27 cases (37.0%), critical limb in 46 cases (63.0%). The 6-yr primary patency rates were 28.1%; 60.3%, the 6-yr secondary patency rates were 37.2±8.4%, 67.0±14.7% in Group A and Group B, respectively (P<0.05). The number of secondary procedures was 31 and 3, respectively (P<0.05). Major amputation at later periods was not needed in Group B, but there were 9 cases in group A (P<0.05).

Conclusion

PTFE graft for above-knee femoropopliteal bypass shows poor long-term patency with a large number of secondary procedures and a higher amputation rate than vein graft in BK Fem-Pop bypass. PTFE graft should be limited to patients with high operative risk, or poor venous graft.

Keywords: Femoro-popliteal bypass, PTFE graft, Autogenous vein graft

Figures and Tables

Table 1

Comparison of clinical characteristics

Table 2

Comparison of primary cumulative patency rates

Kaplan-Meier method; Mean±SE.

Table 3

Comparison of secondary cumulative patency rates

Kaplan-Meier method; Mean±SE.

Table 4

Frequency of secondary procedures for failing and failed graft

^*Others = angioplasty with/without stent, angioplasty, graft extension (P<0.01).

Table 5

Amputation incidence according to time, extend, and operation indication

^*DC = disabling claudication; ^†CLI = critical limb ischemia.

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