Long-term results of infrainguinal revascularization with polytetrafluoroethylene

A ten-year experience

William J. Quiñones-Baldrich, Alfredo A. Prego, Roberto Ucelay-Gomez, Julie A. Freischlag, Samuel S. Ahn, J. Dennis Baker, Herbert I. Machleder, Wesley S. Moore

Research output: Contribution to journalArticle

Abstract

Two hundred fifty-eight patients underwent 322 infrainguinal revascularizations with use of polytetrafluoroethylene (PTFE) between 1978 and 1988. The indication was limb salvage in 190 (59%) reconstructions. Two hundred nineteen (68%) were above-knee, and 75 (23%) were below-knee femoropopliteal bypasses. Twenty-eight (8.6%) were femoralinfrapopliteal bypasses, all done for limb salvage. Follow-up ranged from 24 to 144 months (mean, 66 months). The perioperative mortality rate (1 to 30 days) was 3.4% (9 patients), with no significant difference according to indication (2.9% vs 3.7%). Actuarial primary patency at 8 years for the entire series of femoropopliteal bypasses was 53% (above knee 53%; below knee 39%; p <0.05), and improved with additional procedures for a secondary patency of 72%. Femoropopliteal bypasses done for severe claudication had an 8-year actuarial primary patency of 63%, compared with 38% for limb salvage (p <0.02). Actuarial limb salvage in the latter group at 8 years was 66%. Femoral-infrapopliteal reconstructions with PTFE had a significantly lower primary patency at 3 years (22%, with a 37% limb salvage). Sixty-four percent of the failures for all reconstructions (N = 111) occurred within 12 months, with remarkable stabilization of patency curves beyond that interval. This experience represents the largest reported series of PTFE reconstruction with longest follow-up to date and may serve as a basis for comparison of other conduits. These results suggest an important role for PTFE in femoropopliteal revascularization and a limited role of this prosthetic conduit in femoral-infrapopliteal arterial reconstructions.

Original languageEnglish (US)
Pages (from-to)209-217
Number of pages9
JournalJournal of Vascular Surgery
Volume16
Issue number2
DOIs
StatePublished - 1992
Externally publishedYes

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Limb Salvage
Polytetrafluoroethylene
Knee
Thigh
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Quiñones-Baldrich, W. J., Prego, A. A., Ucelay-Gomez, R., Freischlag, J. A., Ahn, S. S., Baker, J. D., ... Moore, W. S. (1992). Long-term results of infrainguinal revascularization with polytetrafluoroethylene: A ten-year experience. Journal of Vascular Surgery, 16(2), 209-217. https://doi.org/10.1016/0741-5214(92)90109-L

Long-term results of infrainguinal revascularization with polytetrafluoroethylene : A ten-year experience. / Quiñones-Baldrich, William J.; Prego, Alfredo A.; Ucelay-Gomez, Roberto; Freischlag, Julie A.; Ahn, Samuel S.; Baker, J. Dennis; Machleder, Herbert I.; Moore, Wesley S.

In: Journal of Vascular Surgery, Vol. 16, No. 2, 1992, p. 209-217.

Research output: Contribution to journalArticle

Quiñones-Baldrich, WJ, Prego, AA, Ucelay-Gomez, R, Freischlag, JA, Ahn, SS, Baker, JD, Machleder, HI & Moore, WS 1992, 'Long-term results of infrainguinal revascularization with polytetrafluoroethylene: A ten-year experience', Journal of Vascular Surgery, vol. 16, no. 2, pp. 209-217. https://doi.org/10.1016/0741-5214(92)90109-L
Quiñones-Baldrich, William J. ; Prego, Alfredo A. ; Ucelay-Gomez, Roberto ; Freischlag, Julie A. ; Ahn, Samuel S. ; Baker, J. Dennis ; Machleder, Herbert I. ; Moore, Wesley S. / Long-term results of infrainguinal revascularization with polytetrafluoroethylene : A ten-year experience. In: Journal of Vascular Surgery. 1992 ; Vol. 16, No. 2. pp. 209-217.
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abstract = "Two hundred fifty-eight patients underwent 322 infrainguinal revascularizations with use of polytetrafluoroethylene (PTFE) between 1978 and 1988. The indication was limb salvage in 190 (59{\%}) reconstructions. Two hundred nineteen (68{\%}) were above-knee, and 75 (23{\%}) were below-knee femoropopliteal bypasses. Twenty-eight (8.6{\%}) were femoralinfrapopliteal bypasses, all done for limb salvage. Follow-up ranged from 24 to 144 months (mean, 66 months). The perioperative mortality rate (1 to 30 days) was 3.4{\%} (9 patients), with no significant difference according to indication (2.9{\%} vs 3.7{\%}). Actuarial primary patency at 8 years for the entire series of femoropopliteal bypasses was 53{\%} (above knee 53{\%}; below knee 39{\%}; p <0.05), and improved with additional procedures for a secondary patency of 72{\%}. Femoropopliteal bypasses done for severe claudication had an 8-year actuarial primary patency of 63{\%}, compared with 38{\%} for limb salvage (p <0.02). Actuarial limb salvage in the latter group at 8 years was 66{\%}. Femoral-infrapopliteal reconstructions with PTFE had a significantly lower primary patency at 3 years (22{\%}, with a 37{\%} limb salvage). Sixty-four percent of the failures for all reconstructions (N = 111) occurred within 12 months, with remarkable stabilization of patency curves beyond that interval. This experience represents the largest reported series of PTFE reconstruction with longest follow-up to date and may serve as a basis for comparison of other conduits. These results suggest an important role for PTFE in femoropopliteal revascularization and a limited role of this prosthetic conduit in femoral-infrapopliteal arterial reconstructions.",
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