Extensible expanded polytetrafluoroethylene vascular grafts for aortoiliacand aortofemoral reconstruction

The operative experience and medium-term outcome achieved with longitudinal ly extensible ('stretch') expanded polytetrafluoroethylene (ePTFE) bifurcat ed grafts in patients undergoing aortoiliac or aortofemoral reconstruction for occlusive disease at our institution was reviewed. Between 1991 and 199 8, 242 patients received a bifurcated stretch graft. Forty-one patients (17 %) required an aortic endarterectomy, and 63 (26%) underwent femoral artery endarterectomy. 228 patients were followed for a mean of 32 months. One pa tient (0.4%) died perioperatively. The perioperative morbidity included car diac (3.7%). respiratory (2.5%), and renal (3.3%) complications. Three pati ents required early reoperation for bleeding. Four (1.7%) grafts thrombosed within 24 h of surgery: eight additional grafts (3.3%) thrombosed 5-8 mont hs later. There were three postoperative aortic graft infections, one ingui nal infection, three inguinal pseudoaneurysms, and one aortic pseudoaneurys m. Ultrasonography during follow-up showed no periprosthetic fluid collecti ons or graft dilatations. The bifurcated ePTFE stretch graft is suitable fo r aortoiliac and aortofemoral reconstruction, and its physical characterist ics may help to reduce graft-related complications. (C) 2000 The Internatio nal Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.