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Comparison between supra- and infrainguinal inflow sites for infrapopliteal PTFE bypasses with complementary
E Ascher1, M Scheinman, F Mazzariol
1Division of Vascular Surgery, Maimonides Medical Centre, Brooklyn, NY 11219, USA.
Purpose:
the purpose of this retrospective study was to evaluate whether an inflow source proximal to the inguinal ligament had an adverse effect on infrapopliteal bypasses with complementary arteriovenous fistula/vein interposition (AVF/VI) when compared to similar bypasses originating from the common femoral artery (CFA).
Patients And Methods:
over the last seven years, 112 infrapopliteal PTFE bypasses with AVF/VI were performed in 103 patients. There were 58 men and 45 women with ages ranging from 47 years to 88 years (mean 71 years). Indication for surgery was critical ischaemia in all. Seventy-seven (69%) of these were secondary operations and 35 cases (31%) were primary. A 6-mm ringed PTFE graft was used in all cases. A complementary distal AVF/VI was added in all cases. In 56 cases, the bypass originated from the common femoral artery (group I) and, in the remaining 56, it originated from the external or common iliac artery (group II).
Results:
the overall perioperative mortality rate was 3%. The cumulative primary patency rates at 1, 2 and 3 years were 66%, 63% and 53% for group I and 72%, 66% and 59% for group II, respectively (NS).
Conclusions:
these data show that infrapopliteal PTFE bypasses with AVF/VI have similar patency rates when originating from arteries proximal to the inguinal ligament or from the CFA.