Infrageniculate thin-walled PTFE bypass: Preliminary study of 53 cases |
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Authors: | Xavier Barral MD Philippe Youvarlakis MD Christian Boissier MD |
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Institution: | (1) Service de Chirurgie Vasculaire, CHU Nord, Saint-Etienne, 42270 Saint-Priesten Jarez, France |
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Abstract: | Between May 1, 1983 and May 1, 1985, 53 patients whose mean age was 75 years, and who presented with rest pain or ischemic
changes had infrageniculate insertion of femoropopliteal or femorotibial thin-walled polytetrafluoroethylene (PTFE-TW) bypasses.
Occlusive atherosclerotic disease was present in all patients. Postoperative follow-up ranged from 6 to 30 months. One patient
died in the immediate post-operative period whereas 15 others died later during follow-up. There was one case of prosthetic
sepsis. No anastomotic aneurysms occurred. Actuarial analysis of overall patency rates in significant population samples showed
that 88% and 68% of bypasses were functional at one month and two years, respectively. The overall rate of early amputation
was 17%. Overall limb salvage was 67% at 30 months. In patients over 75, 85% of bypasses were patent at one year whereas life
expectancy for one year in this same group of patients was 49%. Although this is a preliminary study, results obtained with
this new material suggest that an average gain of 20% in patency rates can be expected compared to those recorded with standard
PTFE prostheses. The PTFE-TW vascular prosthesis may be the material of first choice for the geriatric patient in order to
promote early hospital discharge and return to the home environment. Even though long-term patency rates of venous grafts
are better, we believe that the use of PTFE-TW prostheses in elderly patients with limited life expectancy may be preferred. |
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Keywords: | Femoropopliteal bypass Femorotibial bypass Polytetrafluoroethylene |
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