Femorodistal PTFE bypass grafting for severe limb ischaemia: Results of a prospective clinical study using a new distal anastomotic technique

Abstract

Objectives: To analyse graft patency and limb salvage following femorodistal bypass with ePTFE using a new distal anastomotic technique. Design: Prospective non-randomised study. Material and methods: One hundred and twenty-nine patients (M:F; 2.23:1; mean age 65.2 ± 10.0 years) underwent 135 operations for severe limb ischaemia. The new anastomosis, constructed entirely from ePTFE, was attached to the popliteal (21), anterior (46) and posterior (52) tibial, and peroneal (16) arteries. Cumulative primary (PPR) and secondary patency rates (SPR), limb salvage and survival were analysed using the Kaplan-Meier method. Results: Median follow-up was 45 (range 6 to 72) months. There was no perioperative mortality. PPR and SPR at 1,2,3,4, and 5 years were 63.0%, 44.9%, 35.7%, 33.1% and 27.6% and 74.5%, 55.2%, 44.8%, 43.0%, and 37.6%, respectively. Cumulative limb salvage was 86.4%, 78.7%, and 73.2% at 1,3, and 5 years, respectively. Conclusions: This new anastomotic design was feasible and resulted in acceptable long-term results.