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The expanded polytetrafluorethylene (PTFE) graft as a vascular substitute
The Journal of Cardiovascular Surgery
|May 1, 1980
Summary
Polytetrafluoroethylene (PTFE) grafts for femoropopliteal artery bypass show high early thrombosis rates. Limited outflow and thrombus formation are key factors contributing to graft occlusion within six months.
Area of Science:
- Vascular Surgery
- Biomaterials Science
Background:
- Femoropopliteal artery occlusion leads to critical limb ischemia.
- Polytetrafluoroethylene (PTFE) grafts are utilized for bypass procedures.
Purpose of the Study:
- To evaluate the early patency and occlusion rates of PTFE grafts in femoropopliteal bypass.
- To identify factors contributing to early graft failure.
Main Methods:
- Ninety-one PTFE grafts (Gore-Tex and Impragrafts) were used in 86 patients for femoropopliteal bypass.
- Indications included ischemic rest pain with ulcerative lesions or gangrene.
- Outflow was assessed, and distal anastomoses were located in the popliteal or crural arteries.
- Postoperative angiography was performed in a subset of patients.
Main Results:
- Early thrombosis incidence was high: 47% within 3 months and 57% within 6 months.
- Limited outflow to one crural artery was noted in 58% of cases.
- Angiographic findings suggested thrombus apposition as a major cause of occlusion.
Conclusions:
- PTFE grafts demonstrate a high rate of early thrombosis in femoropopliteal bypass surgery.
- Limited distal outflow and thrombus formation are significant contributors to early graft occlusion.
