CLINICAL-RESULTS OF INFRAINGUINAL BYPASS USING PLASMA TFE(TM) VASCULAR GRAFT

Twenty-eight infrainguinal bypasses using woven polyethylene terephtha late (PET) vascular graft coated with tetrafluoroethylene (TFE) were e valuated. Distal graft anastomoses were performed to the above-the-kne e (AK) popliteal artery in 18 limbs, below-the-knee (BK) popliteal art ery 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 postoperativel y within five days. During 3 years of follow up, 11 occluded and six f ailing grafts were detected in the FP bypass group. Average patency ti mes for AK FP, BK FP, and FT bypasses were 619.0 +/- 94.5, 226.0 +/- 1 23.0, and 43.4 +/- 24.5 days, respectively. The cumulative patency rat es for AK FP bypass were 81.6 +/- 9.6% at 8 months and 66.7 +/- 12.3% at 1 year. Seventeen limbs with occluded or failing grafts disclosed s ix anastomotic stenoses in five (29%) grafts, occlusive lesions in thr ee (18%) inflow and three (18%) outflow host arteries, and thrombosis of two (12%) inflow bypass grafts. No significant lesions were detecte d in four (23%) occluded grafts following thrombolytic therapy. The re sults 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 t he host artery.