Femoropopliteal bypass; factors influencing long term patency

One hundred and thirty-six patients operated on with femoropopliteal bypass for arterial occlusive disease are retrospectively examined. In 58% of the cases the reversed saphenous vein was used, while 42% had a Dardick Biograft (umbilical vein graft). Patency rate for all grafts was 62.2% at four years. The most important factor for long term patency in our material is the type of graft used. In the saphenous vein group the four years patency rate was 74%, while in the Dardick group 45%. There was no significant difference in patency rate for patients operated on for claudication and those for limb salvage. We found a significantly lower patency rate when the distal anastomosis was placed below the knee. Patients with good arteriographic runoff had better long term patency. The difference was, however, not significant for the prosthetic group. The perioperative mortality was 1.4%. Early graft failure was 4.8% in the autologous vein group and 33% in the umbilical vein group. The majority of amputations occurred in patients with early failure of umbilical vein grafts.