Reoperation for graft failure of femoropopliteal bypass with externally supported knitted Dacron prosthesis

Background Aggressive reoperation for failing or failed femoropopliteal (FP ) bypass has been affirmative despite graft material. There has been no rep ort regarding results of reoperation for FP bypass with externally supporte d knitted Dacron prosthesis (EXS). The aim of this study is to justify aggr essive reoperation of FP bypass with EXS and to examine risk factors affect ing the result of reoperation, Methods. A retrospective review was performed on 204 patients undergoing 21 2 FP bypasses (with EXS between January 1982 and December 1997 and 34 FP EX Ses of 32 patients underwent reoperation for graft failure until March 1998 . The cumulative graft patency CGP) and limb salvage (IS) rate after first reoperation for 34 FP bypass EXS were calculated and the importance of each perioperative factor on GP or LS was estimated by uni- and multivariate an alysis. Results. Reoperated 34 EP EXSes included 12 failing and 22 failed grafts an d 14 limbs with failed grafts underwent reoperation for limb salvage. The G P of 34 grafts and LS of 14 limbs rate were 58 and 67% at 2 years, respecti vely. Univariate analysis identified graft thrombosis (2 years GP; failing graft: failed graft=78: 48%) and continuance of smoking (2 years LS; smoker : non-smoker=43: 100%) as a significant risk factor of GP and LS, respectiv ely, neither of which was significant by multivariate analysis. Conclusions. Early diagnosis and treatment, before graft thrombosis, can le ad to superior durability of GP and discontinuance of smoking is important for LS.