liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
External Support of a Polytetrafluoroethylene Graft Improves Patency for Bypass to Below-Knee Arteries
Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
2013 (English)In: Annals of Vascular Surgery, ISSN 0890-5096, E-ISSN 1615-5947, Vol. 27, no 8, 1124-1133 p.Article in journal (Refereed) Published
Abstract [en]

Background: Patency and limb salvage after synthetic bypass to the arteries below the knee are inferior to that which can be achieved with autologous vein. The use of external support of synthetic polytetrafluoroethylene (PTFE) grafts to the below-knee position has been suggested to improve patency and limb salvage, a problem analyzed in this randomized clinical trial. We examined whether external graft support improves patency and/or limb salvage in patients undergoing reconstruction with synthetic PTFE grafts to the below-knee arteries. less thanbrgreater than less thanbrgreater thanMethods: Three hundred thirty-four patients with critical limb ischemia undergoing PTFE bypass to below-knee arteries were randomly assigned to have an ordinary PTFE graft or one with external support. Follow-up was scheduled until amputation, death, or at most 5 years, whichever event occurred first. less thanbrgreater than less thanbrgreater thanResults: Patients in both the femoropopliteal and femorodistal groups were randomized to have an externally supported PTFE graft (101/195 patients in the femoropopliteal group and 72/139 patients in the femorodistal group). Follow-up information was available for 329 of 334 randomized patients (99%). At 1 year postprocedure, primary patency for below-knee bypass was 0.55 (95% confidence interval [CI], 0.47-0.64) with and 0.42 (95% CI, 0.34-0.50) without externally supported PTFE grafts, and secondary patency was 0.58 (95% CI, 0.51-0.67) and 0.47 (95% CI, 0.39-0.56), respectively. The corresponding figures for limb salvage were 0.75 (95% CI, 0.68-0.82) and 0.69 (95% CI, 0.62-0.77), respectively. The log rank test revealed statistically significant differences between patients with or without externally supported grafts for patency (primary patency: chi(2) = 4.2 [degrees of freedom 1; P=0.041]; secondary patency: chi(2) = 4.3 [degrees of freedom 1; P=0.037]) but not for limb salvage (limb salvage: chi(2) = 0.2 [degrees of freedom 1; P=0.657]). less thanbrgreater than less thanbrgreater thanConclusions: External support to a PTFE graft used for bypass to below-knee arteries improves primary and secondary patency but not limb salvage.

Place, publisher, year, edition, pages
Elsevier Masson / Springer Verlag (Germany) , 2013. Vol. 27, no 8, 1124-1133 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-101383DOI: 10.1016/j.avsg.2013.02.009ISI: 000326294300017OAI: diva2:666380

Funding Agencies|Impra (Tempe, AZ)||W.L. Gore & Associates (Flagstaff, AZ)||

Available from: 2013-11-22 Created: 2013-11-21 Last updated: 2013-11-22

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Lundgren, Fredrik
By organisation
PhysiologyFaculty of Health SciencesDepartment of Thoracic and Vascular Surgery
In the same journal
Annals of Vascular Surgery
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 11 hits
ReferencesLink to record
Permanent link

Direct link