Polytetrafluoroethylene grafts in infrainguinal arterial revascularization. Factors affecting outcome
A. F. AbuRahma, P. A. Robinson, S. P. Stuart, T. A. Witsberger, W. A. Stewart and J. P. Boland
Department of Surgery, West Virginia University Health Sciences Center/Charleston Area Medical Center.
One hundred thirty-seven polytetrafluoroethylene infrainguinal bypass
grafts were performed over 2 years. The results were analyzed using
univariate and multivariate analyses. Our operative mortality was 3.2% and
the post-operative amputation rate was 5.8%. Forty-eight reconstructions
were done for claudication, with a 5-year secondary patency rate of 64%, no
early amputations, and a 2.9% (one limb) late amputation rate. Sixty-six
reconstructions were done for rest pain with a 5-year secondary patency
rate of 58% and a 3-year limb salvage rate of 77%. The 5-year secondary
patency rate for 23 patients with trophic changes was 30%, and the 3-year
limb salvage rate was 71%. Multivariate analysis identified the
ankle-brachial index as the most important independent factor predicting
both primary and secondary graft patency. The cumulative primary and
secondary patency rates for patients with an ankle-brachial index of less
than 0.5 at 78 months was 37% and 46%, respectively; and 57% and 68%,
respectively for patients with an ankle-brachial index of 0.5 or more.
