Prospective controlled study of polytetrafluoroethylene versus saphenous vein in claudicant patients with bilateral above knee femoropopliteal bypasses

被引:58
作者
AbuRahma, AF [1 ]
Robinson, PA [1 ]
Holt, SM [1 ]
机构
[1] W Virginia Univ, Dept Surg, Robert C Byrd Hth Sci Ctr, Charleston Area Med Ctr, Charleston, WV 25304 USA
关键词
D O I
10.1067/msy.2099.99942
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background. Although several studies have compared the patency rates of polytetrafluoroethylene (PTFE) and saphenous vein grafts (SVG) for the above knee location, none have compared the 2 grafts when Implanted in the same patient with claudication who needs bilateral above knee femoropopliteal bypasses Methods. Forty-three patients (86 limbs) with bilateral disabling claudication who had superficial formal artery occlusion and above knee reconstitution with 2- to 3-vessel runoff were analyzed. Patients were treated on one side with PTFE and on the other side with SVG. They were sequentially assigned to PTFE-SVG alternating with SVG-PTFE. All patients were followed using duplex ultrasound and ankle/brachial indexes at I month and every 6 months thereafter . Results. The perioperative complication rates were 5% So PTFE and 12% for SVG, There was no operative death or perioperative amputation for either procedure. The Kaplan-Meier estimate of primary, assisted primary and secondary patency rates at 72 months were 68%, 68%, and 77% for PTFE and 76%, 83%, and 85% Sor SVG. There were no statistically significant differences between primary and secondary patency rates for both grafts; however the assisted primary patency rates were higher SVG (P < .05). The nude limb, salvage rate at 72 months was 98% Sol PTFE and 98% for SVG There were no risk factors identified that had an impact on graft patency. Conclusions. PTFE and SVG for above knee bypasses have comparable patency and limb salvage rates in claudicant patients with bilateral superficial femoral artery occlusion and 2- to 3-vessel runoff. This may justify the use of PTFE for above knee locations in these selected patients.
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页码:594 / 601
页数:8
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