Comparison between supra- and infrainguinal inflow sites for infrapopliteal PTFE bypasses with complementary arteriovenous fistula and vein interposition

Purpose: the purpose of this retrospective study was to evaluate whether an inflow source proximal to the inguinal ligament had an adverse effect on i nfrapopliteal bypasses with complementary arteriovenous fistula/vein interp osition (AVF/VI) when compared to similar bypasses originating from the com mon femoral artery (CFA). Patients and methods: over the last seven years, 112 infrapopliteal PTFE by passes with AFV/VI were performed in 103 patients. There were 58 men and 45 women with ages ranging from 47 years to 88 years (mean 71 years). Indicat ion for surgery was critical ischaemia in all. Seventy-seven (69%) of these were secondary operations and 35 cases (31%) were primary. A 6-mm ringed P TFE graft was used in all cases. A complementary distal AFV/VI was added in all cases. In 56 cases, the bypass originated from the common femoral arte ry (group I) and, in the remaining 56, it originated from the external or c ommon iliac artery (group II), Results: the overall perioperative mortality rate was 3%. The cumulative pr imary patency rates at 1, 2 and 3 years were 66%, 63% and 53% for group I a nd 72%, 66% and 58% for group II, respectively (NS). Conclusions: these data show that infrapopliteal PTFE bypasses with AVF/VI have similar patency rates when originating from arteries proximal to the i nguinal ligament or from the CFA.