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Composite sequential grafts in severe ischemia: a comparative study.

W R Flinn, J B Ricco, J S Yao

Journal of Vascular Surgery

|May 1, 1984

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Composite sequential bypasses, using a short vein segment with polytetrafluoroethylene [PTFE] or entirely with saphenous vein, showed comparable patency rates of 80% at 1-2 years for limb-threatening ischemia.

Area of Science:

Vascular Surgery
Reconstructive Surgery
Peripheral Artery Disease

Background:

Limb-threatening ischemia necessitates effective revascularization procedures.
Saphenous vein and polytetrafluoroethylene [PTFE] grafts are used for bypass surgery.
Optimizing graft material and configuration is crucial for long-term patency.

Purpose of the Study:

To compare the patency rates of different sequential bypass graft configurations.
To evaluate the efficacy of composite sequential grafts in patients with critical limb ischemia.

Main Methods:

A retrospective study of 59 patients undergoing 64 sequential bypass grafts from 1978 to 1983.
Grafts included reversed saphenous vein alone, composite sequential (PTFE proximal, vein distal), and entire PTFE.

Related Experiment Videos

Graft patency was assessed using Doppler ankle pressure and angiography over 27 months.

Main Results:

Composite sequential grafts with distal vein segments achieved 80% 1- and 2-year patency rates, similar to reversed saphenous vein grafts.
Bypasses solely with PTFE grafts had significantly lower 1- and 2-year patency rates (52% and 47%, respectively).

Conclusions:

Composite sequential bypasses utilizing a short vein segment are a viable alternative for revascularization.
This approach offers comparable patency to traditional reversed saphenous vein bypasses.
Composite grafts provide a successful option when vein quality is a concern.