A prospective randomized trial comparing vein with polytetrafluoroethylene in above-knee femoropopliteal bypass grafting

被引:90
作者
Burger, DHC
Kappetein, AP
van Bockel, JH
Breslau, PJ
机构
[1] Rode Kruis Ziekenhuis, Dept Surg, NL-2566 MJ The Hague, Netherlands
[2] Leiden Univ, Med Ctr, Dept Surg, Div Vasc Surg, Leiden, Netherlands
[3] Leiden Univ, Med Ctr, Dept Cardiothorac Surg, Leiden, Netherlands
关键词
D O I
10.1067/mva.2000.106496
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: Despite many clinical studies, there is still uncertainty as to whether venous material is superior to polytetrafluoroethylene for femoropopliteal reconstruction proximal to the knee joint. Supported by early satisfactory results with thin-walled, stretched polytetrafluoroethylene for suprageniculate bypass grafts, a prospectively randomized clinical trial was designed to evaluate the effectiveness of reversed saphenous vein in comparison with that of polytetrafluoroethylene in above-knee arterial reconstruction. Methods: In a a-year period, 151 above-knee femoropopliteal bypass graft operations were performed in 136 patients (77 male, 59 female). The indication for operation was severe claudication in 120 cases, rest pain in 20 cases, and ulceration in 11 cases. For the bypass graft, a reversed saphenous vein was used in each of 75 cases, and a polytetrafluoroethylene prosthesis was used in each of 76 cases. Preoperative risk factors were diabetes (24%), a history of myocardial infarction (23%), and current status with respect to smoking (74%). There was no hospital mortality; 5% of patients had minor postoperative complications. Results: After 2 years, the primary patency was 83% for saphenous vein and 67% for polytetrafluoroethylene (P = .065); the secondary patency was 83% for saphenous vein and 77% for polytetrafluoroethylene (P = .298). During a follow up period of 2 years, we found no statistically significant difference in primary and secondary patency between saphenous vein and polytetrafluoroethylene. We found no predictive factor for occlusion of either bypass graft. Conclusion: The use of polytetrafluoroethylene above the knee is a reasonable alternative in femoropopliteal bypass grafting that is associated with acceptable short-term patency rates. (J Vasc Surg 2000;32:278-83.).
引用
收藏
页码:278 / 283
页数:6
相关论文
共 15 条
[1]  
AALDERS GJ, 1992, J VASC SURG, V16, P816
[2]   Prosthetic above-knee femoropopliteal bypass grafting: Results of a multicenter randomized prospective trial [J].
Abbott, WM ;
Green, RM ;
Matsumoto, T ;
Wheeler, JR ;
Miller, N ;
Veith, FJ ;
Suggs, WD ;
Hollier, L ;
Money, S ;
Garrett, HE ;
Moore, WS ;
Dean, RH ;
Cronenwett, JL ;
Carter, S ;
Greenhalgh, RM ;
ODonnell, TF .
JOURNAL OF VASCULAR SURGERY, 1997, 25 (01) :19-28
[3]  
EVANS LE, 1981, SURGERY, V89, P16
[4]  
LONDREY GL, 1991, J VASC SURG, V13, P631
[5]   CHOICE OF MATERIAL FOR ABOVE-KNEE FEMOROPOPLITEAL BYPASS GRAFT [J].
MICHAELS, JA .
BRITISH JOURNAL OF SURGERY, 1989, 76 (01) :7-14
[6]   POLYTETRAFLUOROETHYLENE IN ABOVE-KNEE ARTERIAL BYPASS-SURGERY FOR CRITICAL ISCHEMIA [J].
ORIORDAIN, DS ;
BUCKLEY, DJ ;
ODONNELL, JA .
AMERICAN JOURNAL OF SURGERY, 1992, 164 (02) :129-131
[7]  
Patterson R B, 1990, Ann Vasc Surg, V4, P338, DOI 10.1007/BF02000496
[8]   Should vein be saved for future operations? A 15-year review of infrainguinal bypasses and the subsequent need for autogenous vein [J].
Poletti, LF ;
Matsuura, JH ;
Dattilo, JB ;
Posner, MP ;
Lee, HM ;
Scouvart, M ;
Sobel, M .
ANNALS OF VASCULAR SURGERY, 1998, 12 (02) :143-147
[9]   LONG-TERM RESULTS WITH THE ABOVE-KNEE POPLITEAL EXPANDED POLYTETRAFLUOROETHYLENE GRAFT [J].
PRENDIVILLE, EJ ;
YEAGER, A ;
ODONNELL, TF ;
COLEMAN, JC ;
JAWOREK, A ;
CALLOW, AD ;
MACKEY, WC ;
DETERLING, RA .
JOURNAL OF VASCULAR SURGERY, 1990, 11 (04) :517-524
[10]   LONG-TERM RESULTS OF INFRAINGUINAL REVASCULARIZATION WITH POLYTETRAFLUOROETHYLENE - A 10-YEAR EXPERIENCE [J].
QUINONESBALDRICH, WJ ;
PREGO, AA ;
UCELAYGOMEZ, R ;
FREISCHLAG, JA ;
AHN, SS ;
BAKER, JD ;
MACHLEDER, HI ;
MOORE, WS .
JOURNAL OF VASCULAR SURGERY, 1992, 16 (02) :209-217