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Clinical Results of Infrainguinal Bypass Using Plasma TFE^TM Vascular Graft

Department of Surgery II, Kyushu University, Fukuoka, Japan

Morris D. Kerstein, MD, FACA

Allegheny University Hospitals/Allegheny University of the Health Sciences, Division of Vascular Surgery, Department of Surgery, Medical College of Pennsylvania and Hahnemann University, Philadelphia, Pennsylvania

Takafumi Maekawa, MD, PhD

Department of Surgery II, Kyushu University, Fukuoka, Japan

Thomas E. Arnold, MD

Department of Surgery, Division of Vascular Surgery, Health Sciences Center, University at Stony Brook, Stony Brook, New York

Subhahasis Maitra, MD

Teruo Matsumoto, MD, PhD, FACA

Allegheny University Hospitals/Allegheny University of the Health Sciences, Division of Vascular Surgery, Department of Surgery, Medical College of Pennsylvania and Hahnemann University, Philadelphia, Pennsylvania

Twenty-eight infrainguinal bypasses using woven polyethylene terephthalate (PET) vascular graft coated with tetrafluoroethylene (TFE) were evaluated. Distal graft anastomoses were performed to the above-the-knee (AK) popliteal artery in 18 limbs, belowthe-knee (BK) popliteal artery in three limbs, and tibial arteries in seven limbs. No early graft occlusions (within 30 days) occurred in femoropopliteal (FP) bypasses, whereas 5/7 (71%) femorotibial (FT) bypasses occluded postoperatively within five days. During 3 years of follow up, 11 occluded and six failing grafts were detected in the FP bypass group. Average patency times for AK FP, BK FP, and FT bypasses were 619.0 4.5, 226.0 ± 23.0, and 43.4 ±4.5 days, respectively. The cumulative patency rates for AK FP bypass were 81.6 ±.6% at 8 months and 66.7 ±12.3% at 1 year. Seventeen limbs with occluded or failing grafts disclosed six anastomotic stenoses in five (29%) grafts, occlusive lesions in three (18%) inflow and three (18%) outflow host arteries, and thrombosis of two (12%) inflow bypass grafts. No significant lesions were detected in four (23%) occluded grafts following thrombolytic therapy. The results indicated that this graft has acceptable antithrombogenicity in FP position because of no early graft occlusion, and the common causes of graft failure were anastomotic stenoses and occlusive lesions of the host artery.

Vascular and Endovascular Surgery, Vol. 32, No. 3, 233-239 (1998)
DOI: 10.1177/153857449803200305


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