Infragenicular polytetrafluoroethylene bypass with distal vein cuffs for limb salvage: A contemporary series

Stephen R. Lauterbach, Gustavo A. Torres, George Andros, Robert W. Oblath, R. James Valentine, James Debord, Sachinder Hans

Research output: Contribution to journalReview article

25 Scopus citations

Abstract

Hypothesis: Infragenicular polytetrafluoroethylene (PTFE)-venous cuff bypass grafting provides acceptable graft patency and limb salvage rates for limb salvage. Design: Retrospective clinical review of a consecutive series. Setting: Vascular surgical practice during the interval October 1, 2000, to September 1, 2004. Patients: Fifty-one male and 49 female patients whose mean age was 76.9 years were operated on for tissue loss (67%), chronic rest pain (28%), and severe claudication (6%). Fifty-two percent of patients were diabetic and 49% had undergone previous leg bypass surgery. All patients had absent or inadequate greater saphenous vein, and 84 patients had absent or inadequate arm vein. Interventions: One hundred five infragenicular PTFE bypasses were performed in these 100 patients. Distal targets were the infragenicular popliteal (40), posterior tibial (35), anterior tibial (16), and peroneal arteries (14). Sixty-eight venous cuffs were constructed from lesser saphenous vein. Main Outcome Measures: Graft patency, limb salvage, and patient survival were analyzed. Results: Twelve early graft failures resulted in 7 leg amputations. The mean ± SE 3-year primary patency and limb salvage rates were 64.4% ± 12.8% and 74.4% ± 11.9%, respectively. Perioperative mortality was 2.9% and 3-year survival was 38%. Graft follow-up ranged from 1 to 47 months with a mean of 13 months using life-table methods. Conclusions: For patients requiring arterial revascularization for limb salvage, in which autologous venous conduit is unavailable, distal venous cuff-PTFE bypass provides acceptable patency and limb salvage rates when viewed in the context of short life expectancy for these elderly patients.

Original languageEnglish (US)
Pages (from-to)487-494
Number of pages8
JournalArchives of Surgery
Volume140
Issue number5
DOIs
StatePublished - May 1 2005

ASJC Scopus subject areas

  • Surgery

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    Lauterbach, S. R., Torres, G. A., Andros, G., Oblath, R. W., Valentine, R. J., Debord, J., & Hans, S. (2005). Infragenicular polytetrafluoroethylene bypass with distal vein cuffs for limb salvage: A contemporary series. Archives of Surgery, 140(5), 487-494. https://doi.org/10.1001/archsurg.140.5.487