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The distaflo graft: a valid alternative to interposition vein?
R K Fisher1, U J Kirkpatrick, T V How
1Regional Vascular Unit, Royal Liverpool University Hospital, UK.
Summary
The Distaflo graft shows comparable one-year patency, limb salvage, and survival rates to the Miller cuff in patients with critical limb ischemia. This suggests Distaflo is a viable alternative for distal prosthetic arterial reconstruction.
Area of Science:
- Vascular Surgery
- Prosthetic Arterial Reconstruction
- Critical Limb Ischemia Treatment
Background:
- The Distaflo graft aims to inhibit myointimal hyperplasia by optimizing hemodynamic forces at the distal anastomosis.
- This study evaluates the early clinical outcomes of the Distaflo graft in patients lacking autologous veins.
Purpose of the Study:
- To assess the one-year cumulative patency, limb salvage, and survival rates of the Distaflo graft.
- To compare the performance of the Distaflo graft against historical control data from Miller cuff grafts.
Main Methods:
- Prospective study involving infrainguinal bypass using Distaflo in patients with critical limb ischemia.
- Clinical and Duplex assessments were performed.
- Kaplan-Meier analysis calculated one-year cumulative patency, limb salvage, and survival rates; Log rank test compared with historical Miller cuff grafts.
Main Results:
- Fifty Distaflo grafts were implanted in 46 patients over 29 months.
- One-year cumulative rates for Distaflo were: patency 39%, limb salvage 50%, survival 82%.
- These rates were not statistically different from the historical Miller cuff control group (patency 49%, limb salvage 56%, survival 85%; p > 0.39).
Conclusions:
- The Distaflo graft demonstrated similar one-year clinical outcomes to the Miller cuff in this non-randomized study.
- Distaflo may be a suitable alternative for distal prosthetic arterial reconstruction in critical limb ischemia cases.