Abstract
Purpose: The purpose of this study is to evaluate early and late results of femoro-crural bypass using polytetrafluoroethylene (PTFE)-vein composite grafts or PTFE grafts with distal vein cuffs for arteriosclerosis obliterans (ASO) and to compare those with the results of autogenous vein bypass. Methods: The clinical records of 58 patients who underwent femoro-crural bypass for ASO from December 1998 to December 2005 were retrospectively reviewed. The backgrounds and the results of 28 PTFE-vein composite grafts or PTFE grafts with distal vein cuffs (PTFE-vein) and 30 autogenous vein bypass (AV), including morbidity, mortality, graft patency, limb salvage rate and survival rate, were compared. Results: Average age of patients (76 y.o. vs. 72 y.o.) and the rate of redo operation (32% vs. 7%) were higher and the complication rate of hypertension (71% vs. 93%) was lower in PTFE-vein group. The cumulative primary, secondary patency and limb salvage rate of PTFE-vein were 67%, 74% and 81% at 1 year and those of AV were 83%, 90% and 100% at 2 years, respectively. AV was superior to PTFE-vein in both primary and secondary patency. There was no significant difference in survival rates. Conclusion: AV should be selected as the first choice for femoro-crural bypass, while PTFE-vein can be an alternative procedure for patients with critical limb ischemia whose autogenous vein is not available or not sufficient.
