Preferential use of vein for above-knee femoropopliteal grafts
| Autor: | Y.G. Wilson, I.C. Currie, Roger N. Baird, PM Lamont, M. G. Wyatt |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Limb salvage Femoropopliteal bypass Transplantation Autologous Amputation Surgical Veins chemistry.chemical_compound Humans Medicine Knee Popliteal Artery Vein Polytetrafluoroethylene Vascular Patency Aged Aged 80 and over Medicine(all) business.industry Disease progression Graft Occlusion Vascular Patient survival Middle Aged Blood Vessel Prosthesis Surgery Femoral Artery medicine.anatomical_structure Amputation chemistry Female Radiology Amputation level Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. 10:220-225 |
| ISSN: | 1078-5884 |
| DOI: | 10.1016/s1078-5884(05)80116-9 |
| Popis: | Objectives: Many centres preferentially use polytetrafluoroethylene (PTFE) for above-knee femoropopliteal bypass as surgery is simplified and patency rates are comparable to vein, which is preserved for subsequent revisions or for distal disease progression. In this Unit, vein remains first choice graft material. The aim of this study was to audit our results with respect to above-knee bypass to establish the demand for vein for secondary reconstruction and to document the ultimate fate of the limb. Patients: Between 1983 and 1992, 112 above-knee reconstructions were performed on 109 patients (89 vein and 23 PTFE grafts). PTFE was used where vein was absent or inadequate. Life table analysis of primary graft patency, limb salvage and patient survival up to 36 months follow-up concurs with previously reported series. Results: Twenty-eight vein grafts (31%) and 11 PTFE grafts (48%) occluded during a median follow-up of 64 months (8–116 months). In only four cases was vein required for secondary procedures. The remainder were salvaged by thrombectomy and local procedures for technical problems. Amputation rates following graft occlusion were 12% in the vein group (20% of these being above-knee) as against 26% in the PTFE group (80% above knee). Conclusions: The demand for vein for secondary procedures is low. Amputation rates when vein grafts do occlude are half those of PTFE and amputation level is significantly influenced by graft type. We advocate preferential use of vein in above-knee femoropopliteal bypass. |
| Databáze: | OpenAIRE |
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