Is the preferential use of ePTFE grafts in femorofemoral bypass justified?

The choice of prosthetic graft material for cross-femoral bypass has been e volving in the past two decades. Expanded polytetrafluoroethylene (ePTFE) h as become our preferred graft material since 1995. However, few studies hav e looked into the optimal graft material in this procedure. Justification f or the preferential use of ePTFE graft in lower limb revascularization rema ins unknown. The aim of the present study was to compare the long-term outc omes of Dacron and ePTFE grafts in femorofemoral bypass. The records of 61 consecutive patients who underwent femorofemoral bypass at the University o f Hong Kong Medical Center from 1981 to 1998 were retrospectively reviewed. Dacron grafts were used in 27 patients and 34 patients had ePTFE grafts. T he demographic features, patency, and limb salvage rates of the two groups of patients were compared. The 3-year primary patency rates of Dacron and e PTFE grafts were 85% (SE = 9.5%) and 66% (SE = 14.5%), respectively. The di fference was not statistically significant. The limb salvage rates of Dacro n and ePTFE grafts were 91% and 83% at 3 years, respectively (p = 0.27). Th e long-term outcomes of Dacron and ePTFE grafts in femorofemoral bypass wer e equivalent. The preferential use of ePTFE graft in femorofemoral bypass i s not evidence based. Selection of an appropriate prosthetic graft for femo rofemoral bypass should be based on the cost and its handling characteristi cs.