Tibial and peroneal artery bypasses using polytetrafluoroethylene (PTFE) with an interposition vein cuff

The combined results of femoro-distal bypasses using prosthetic material wi th vein cuffs from two separate vascular units is presented. Method: Over t he last five years, 89 infrainguinal bypasses using polytetrafluoroethylene (PTFE) with a distal interposition vein cuff to a tibial artery have been performed in two centres, All operations were for critical limb ischaemia, The mean age was 72 years (47 - 90), there were 46 males and 43 females, 27 of a hom were diabetic. Twenty-eight patients had a history of angina and/ or previous myocardial infarct, The median follow-up was 12 months (0 - 68 months). Results: During the follow-up period there were 28 deaths, 35 majo r limb amputations and 44 graft failures. The graft patency rates at 12 and 24 months were 50 and 32%, and limb salvage rates were 53 and 44%, respect ively. The patient survival rates were 66 and 61%, respectively. Conclusion : The authors believe that the likely improvement in pain free quality of l ife the patient may enjoy with a successful bq pass shifts the balance in s ome individuals towards bypass surgery using PTFE with a vein cuff to a tib ial artery when such an option is possible.