FEMOROPOPLITEAL BYPASS WITH EXTERNALLY SUPPORTED KNITTED DACRON GRAFTS - A FOLLOW-UP OF 200 GRAFTS FOR ONE TO 12 YEARS

Purpose: This article reports our experience with externally supported, preclotted knitted Dacron grafts in femoropopliteal bypass. Methods: This is a retrospective analysis of a consecutive series of 154 patients who received 200 grafts (175 above knee and 25 below knee). Follow-up extended to 12 years (mean 59 1/2 months). Results: Primary patency rates for the entire series were 75%, 70%, and 47% at 3, 5, and 10 years, respectively. Above-knee grafts had 76%, 71%, and 50% rates and 3, 5, and 10 years, respectively. Below-knee grafts had 65% and 57% at 3 and 5 years, respectively. Limb-salvage rates were 87%, 79%, and 73% at 3, 5, and 10 years, respectively, for the 57 limbs operated on because of critical ischemia. The most significant predictor of graft failure was poor runoff as determined by preoperative arteriography. The effect of poor runoff was most pronounced in the first 3 months. Conclusion: Externally supported, preclotted knitted Dacron grafts provide encouraging primary patency rates for above-knee femoropopliteaI bypass. Poor leg vessel runoff is a major determinant of early graft failure.