Factors affecting patency of femoropopliteal bypass grafts

A 16 year review of femoropopliteal bypass grafts identified five factors with significant influence on long term patency. Most important was the nature of the graft itself, with vein grafts having superior long term performance as compared to a variety of prosthetic grafts. Arteriographic runoff, indications for operation, site of the distal anastomosis and prior femoropopliteal operation had a major influence on long term patency of prosthetic grafts but rather minimal effects on the patency of autogenous vein grafts. The influence of several variables proved cumulative, leading to a favorable subset of patients in whom prosthetic grafts may approach long term performance of vein grafts. Differences in such key variables is a major contribution to the widely differing patency rates of previous studies and must be carefully controlled in any future prospective studies.