Polytetrafluoroethylene Bypasses To Infrapopliteal Arteries Without Cuffs, Patches, Or Other Adjunctive Procedures: A 20-Year Experience

Objectives: Polytetrafluoroethylene (PTFE) tibial and peroneal bypasses without vein cuffs or patches have been used for limb salvage when autologous vein is not available. This reviews our 20-year experience.
Methods: A retrospective analysis was performed on a group of 259 patients undergoing limb salvage between June 1983 and June 2003. These 259 patients underwent 271 PTFE bypasses to a tibial or peroneal artery without any adjunctive procedure. Tourniquet control of the tibial or peroneal artery was used in the majority of cases (85%). Cumulative life-table primary and secondary patency and limb salvage rates were calculated for those bypasses performed between June 1983 and June 1993 (Group I). These were compared to those performed between June 1993 and June 2003 (Group II). Total distal anastomotic time was also recorded. Data was analyzed using Fischer's exact test.
Results: Overall 3-year primary (P) and secondary (S) patency, limb salvage rates (L), and total distal anastomotic time (T) for Groups I and II are outlined in the Table; *p<0.05)
Conclusion: PTFE bypasses without adjunctive procedures to infrapopliteal arteries are an option for those patients without autologous vein. Meticulous attention to the distal anastomosis is an important factor in predicting primary patency of these grafts.