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April 1993

Polytetrafluoroethylene Grafts in Infrainguinal Arterial Revascularization: Factors Affecting Outcome

Author Affiliations

From the Department of Surgery, West Virginia University Health Sciences Center/Charleston Area Medical Center, Charleston, WVa.

Arch Surg. 1993;128(4):417-422. doi:10.1001/archsurg.1993.01420160055008

• 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 postoperative 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.

(Arch Surg. 1993;128:417-422)

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