The veterans administration and academic surgery. A report from the committee on issues of the association for academic surgery 1979 meeting

This is a retrospective study of 139 consecutive femoropopliteal bypass grafts (64 saphenous vein and 75 polytetrafluoroethylene (PTFE)) performed at one institution from 1972 to 1978 with a maximum of 93 and 63 months follow-up, respectively. Operative indications were intermittent claudication (53.2%), ischemic rest pain (15.1%), and gangrene (31.6%). Associated diseases were heart disease (54.7%), diabetes (36.7%), and hypertension (24.5%). Overall mortality was 2.9%. Patency by life-table analysis is as follows:

a.

					Patency (%)
Graft	1 month	6 months	1 year	2 years	3 years	4 years	5 years	6 years	7 years
Vein	92	84	71	59	49	41	41	30	30
PTFE	93	84	75	51	48	39	31	Xa	Xa

a

No data. There is no significant difference in overall patency between vein and PTFE ($\text{P > 0.8}$). Both grafts were compared by similar runoff: poor (isolated popliteal and one vessel—24.5%) and good (two and three vessels—72.7%)—P values were <0.05 and >0.2, respectively. Analysis of patency as compared to operative indications for both grafts were: claudication, $\text{P > 0.3}$; rest pain, $\text{P > 0.2}$; and gangrene, $\text{P > 0.2}$. Patency was then compared to distal anastomotic site—P values were greater than 0.2 between vein and PTFE at either above the knee or below the knee sites. Conclusion: PTFE is comparable to saphenous vein as a femoropopliteal bypass material with the exception of use in poor runoff situations.