[Five years experience with infra-inguinal arterial reconstruction: a comparison of venous with PTFE bypass]

Since January 1983 one surgeon of our team has performed 200 infrainguinal arterial reconstructions. Our patients had a mean age of 72 years and suffered from multiple concomitant diseases (coronary heart disease 35%, cerebro-vascular insufficiency 15%, hypertension 49% and diabetes mellitus 34%). The indication for arterial reconstruction was a chronic critical ischemia in every case. 154 autologous veins and 46 PTFE prosthesis had to be implanted. The former consisted in 64% in a femoropopliteal and in 35% femorodistal bypass graft; respective values of the latter group were 80% and 20%. The cumulative survival rates of two collectives were nearly identical. More than 50% of our patients died in the 4 years observation period. The life table patency rates differed statistically significant (p less than 0.001). The cumulative 5 year patency amounted to 85% in case of a vein graft and to 43% if a PTFE prosthesis was inserted. Extremely poor results were achieved in case of a PTFE prosthesis with a distal anastomosis to a single crural artery; just one out of 6 procedures was successful after two years.