Femorodistal ePTFE-bypass grafting using femorocrural patch prosthesis (FCPP). Results of a prospective clinical study

Femorodistal bypass using exclusively PTFE is known to have a poor prognosi s, mostly because of the development of myointimal hyperplasia (MIH). Sever al vein patch techniques are established but the role of hemodynamics withi n the anastomotic site has only been explained insufficiently and is hardly considered clinically. In a prospective study, between 6/1992 and 7/1998 1 29 patients (89 m/40 f, mean age 65.2 +/- 10.0 years) with critical limb is chemia and no usable saphenous vein were included to undergo femorodistal e PTFE bypass,grafting with a new, hemodynamically optimized distal end-to-si de anastomosis. Patients were followed at 6-month intervals with clinical i nvestigation and color-coded Doppler sonography. Primary and secondary graf t patency (PPR, SPR), limb salvage, and patient survival were calculated ac cording to Kaplan-Meier. With a median follow-up of 45 (range 6 to 72) mont hs, PPR and SPR at 1, 3 and 5 years were 63.0, 35.7 and 27.6 % and 74.5, 44 .8 %, and 37.6 %, respectively. Limb salvage at 1, 3 and 5 years was 86.4 % , 78.7 % und 73.2 %. There was no perioperative mortality. Graft infection occurred in 7 patients (5.2 %). ePTFE bypass grafting represents a valuable option for infragenicular and c rural reconstruction in the absence of autologous vein. The new anastomotic design was feasible and represents another adjunct to possibly improve pat ency of femorodistal bypass allografts.