Distal femoropopliteal bypass using a - Europe PMC
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Distal femoropopliteal bypass using a - Europe PMC
consists ofa proximal segment of6mm expanded PTFE (Gore-. Tex®; or Impra®) *, anastomosed to transposed non-reversed auto- logous saphenous vein.
Annals of the Royal College of Surgeons of England (1989) vol. 71
Distal femoropopliteal bypass using a composite graft of PTFE and non-reversed saphenous vein PETERJ HOLDSWORTH FRCS Surgical Registrar
PETER S RIDDELL FRACS Surgical Registrar
STEPHEN H LEVESON Mt) FRCS Consultant Surgeon York District Hospital, York Key words: BELOWV KNEIE FEMOROPGPI.IlFEAI. BYPASS; COMPOSITE GRAFT; NON-REVERSED SAPHENOUS VEIN
Summary The results of femoropopliteal bypass to the infragenicular poplileal artery, in the absence of suitable saphenous vein have, in the main, been disappointing. We present a new type of composite graft,for use when the distal anastomosis is below the knee, which avoids the potential problems of prosthetic graft alone. The graft consists of a proximal segment of 6mm expanded PTFE (GoreTex®; or Impra®) *, anastomosed to transposed non-reversed autologous saphenous vein. Forty-two patients were studied following unilateral, below knee composite femoropopliteal graft surgery for severe claudication or critical ischaemia. Pressure indices were calculated along with intraoperativeflow rate, and all patients werefollowed up at regular intervals to assess graft patency. During the study period three patients died and graft occlusion occurred in a further eight. Analysis of the cumulative patency curve revealed that the majority of occlusions occurred in the first 3 months. The patency at 12 and 18 months was encouraging with values of 84% and 79% respectively. Comparison of pressure indices revealed a significant increase following surgery (P
