Early experience with a new PTFE graft below the inguinal ligament

Between July 1984 and July 1985, 65 expanded polytetrafluoroethylene grafts (Vitagraft) were implanted in the infrainguinal position in 51 patients, including 41 men and 10 women, with an average age of 63 years. The indications for surgery were severe claudication (36 grafts) or ischemic necrosis of the extremities (29 grafts). Thirteen of the patients (25%) had had a previously placed infrainguinal graft of another type that had failed, requiring reoperation. Proximal vascular reconstruction (consisting of ten aorto-femoral and two femoro-femoral bypasses) was performed in 12 patients who had 16 grafts. Simultaneous aortocoronary bypass surgery was done in conjunction with a femoral-popliteal bypass in six patients. The site of distal anastomosis was the suprageniculate popliteal artery in 21 grafts (32%), the infrageniculate popliteal artery in 33 grafts (51%), tibio-peroneal trunk in seven grafts (11%), and the posterior tibial artery in four grafts (6%). The mean follow-up was 9.6 months (range, 1 to 16 months). Two grafts (3.0%) failed early (< 30 days). Another three grafts (4.6%) occluded between 1 and 6 months postoperatively, and five occluded after 6 months. The cumulative patency rate at 15 months was 78.8%. Limb salvage was not possible in three patients, who underwent amputation because of multiple previous operations and a lack of distal run-off. There were no operative deaths, graft infections, aneurysms, or untoward reactions (including seromas) along the graft tracts. At this early follow-up date, we have not encountered the complications normally associated with other grafts; our early results indicate that continued clinical use is warranted.