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July 1980

Below-Knee Bypass for Limb Salvage: Comparison of Autogenous Saphenous Vein, Polytetrafluoroethylene, and Composite Dacron-Autogenous Vein Grafts

Author Affiliations

From the Veterans Administration Medical Center, East Orange, NJ, and the Division of Vascular Surgery, College of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark.

Arch Surg. 1980;115(7):833-837. doi:10.1001/archsurg.1980.01380070023005

• Autogenous saphenous vein was used preferentially for 92 below-knee bypass procedures (44 femoral-distal popliteal and 48 femoral-distal tibial or peroneal) performed for limb salvage in 87 adult male patients during a 30-month period of study. When a saphenous vein was unavailable or of unsuitable length or diameter, we randomly used expanded polytetrafluoroethylene (PTFE) and composite Dacron-autogenous vein (DV) grafts. With good run-off, all grafts have remained patent. However, with poor run-off, cumulative patency by the life table method decreased to 54% for autogenous saphenous vein and 45% for PTFE, which was not significantly different. All composite DV grafts used with poor run-off became occluded within the first ten months of the study. We continue to recommend use of autogenous saphenous vein for revascularization of the ischemic lower extremity. When a suitable saphenous vein is unavailable, PTFE is a satisfactory alternative graft that is superior to composite DV grafts.

(Arch Surg 115:833-837, 1980)