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Early Results for Below-Knee Bypasses Using Distaflo

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Rajesh Malik, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Rakhsim Yakubov, BA

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Paul Gagne, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Bart E. Muhs, MD, PhD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Caron Rockman, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Neal S. Cayne, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Glenn R. Jacobowitz, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Patrick J. Lamparello, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Mark A. Adelman, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York

Thomas S. Maldonado, MD

Division of Vascular Surgery, Department of Surgery, New York University School of Medicine, New York, Thomas.maldonado{at}nyumc.org

In patients who require lower extremity revascularization, prosthetic graft is a reasonable alternative in the absence of a suitable autologous vein conduit. However, prosthetic bypass grafts have limited patency, especially for infrageniculate reconstruction. Polytetrafluoroethylene grafts were geometrically modified at the distal end to increase their patency. The authors reviewed their experience with the Distaflo graft in patients who required lower extremity below-knee popliteal and tibial bypasses when no suitable autologous vein conduit was available. Chart review was conducted of the 57 patients who underwent 60 lower extremity bypasses over a 3-year period between June 2003 and April 2006. Twenty-four revascularizations were constructed to the tibial outflow sites, whereas the remaining grafts were placed to the below-knee (28) and above-knee (8) popliteal artery, respectively. Study endpoints were primary, assisted primary, secondary patency, and limb salvage at the time of follow-up. Distaflo bypass was performed at the infrageniculate level in 86.7% of cases (28 below-knee popliteal, 24 tibial). Mean follow-up time was 12 months (range, 0.5-37.5 months). At 1 year, primary, assisted primary, and secondary patencies and limb salvage rates for below-knee popliteal bypasses were 83.5%, 89.5%, 94.7%, and 94.4%, respectively. Primary, assisted primary, and secondary patencies and limb salvage rates for tibial bypasses were 44.4%, 44.4%, 63.2%, and 74.9%, respectively. Distaflo precuffed graft is a good alternative conduit for below-knee popliteal and tibial lower extremity reconstructions in the absence of an autologous vein and appears to have promising early patency and limb salvage rates even when used for tibial bypasses.

Key Words: Distaflo • infrageniculate • tibial • arterial bypass

This version was published on January 1, 2009

Vascular and Endovascular Surgery, Vol. 42, No. 6, 561-566 (2009)
DOI: 10.1177/1538574408322659


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