Four years' results of a prospective, randomized clinical trial comparing polytetrafluoroethylene and modified human umbilical vein for below-knee femoropopliteal bypass

Eickhoff, J. H.; Broomé, A; Ericsson, B.; Hansen, Holger Bernt; Kordt, K. F.; Mouritzen, C; Kvernebo, Knut; Norgren, Lars; Rostad, Hans; Trippestad, Arne

doi:10.1016/0741-5214(87)90311-9

Cited by 63 publications

(21 citation statements)

References 6 publications

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“…Although there seems little doubt that autogenous vein is superior to the most common alternatives, polytetrafluoroethylene (PTFE) and umbilical vein (UV), the relative merits of PTFE and UV, how well they perform in comparison with autogenous vein at different levels of distal anastomosis, and whether or not in situ bypass is innately superior to reversed saphenous vein--all are unsettled issues despite results from several prospective randomized trials. [1][2][3] This article presents data bearing on these questions, gathered from the follow-up at 3 years, of almost 250 well-documented cases of difficult distal bypass, originally entered in a trial of the efficacy ofdextran 40 in preventing early graft thrombosis.…”

mentioning

confidence: 99%

Factors affecting the patency of infrainguinal bypass

Rutherford¹,

Jones²,

Bergentz³

et al. 1988

Journal of Vascular Surgery

193

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Two hundred forty-nine well-characterized difficult distal bypasses, entered into a multicenter dextran 40 trial, were reevaluated after 3 years. Seventy in situ (IS) vein grafts, 49 reversed saphenous (RS) vein grafts, 60 polytetrafluoroethylene (PTFE) grafts, and 70 umbilical vein (UV) grafts were used. Primary and secondary patency rates at 3 years were, respectively, 84% and 90% for IS, 66% and 73% for RS, 35% and 48% for PTFE, and 24% and 32% for UV. Subgroup analysis according to the site of distal anastomosis showed no significant differences in primary patency among these grafts at the above-knee level but significant differences between both vein grafts (IS and RV) and the others (PTFE and UV) below the knee (78% vs 31%, respectively). This difference increased at the tibial level (78% vs 10%) but there was also a significant difference between IS grafts (88%) and RS grafts (63%) at this level. Hazard functional analysis showed all grafts except IS grafts begin to fail at an increasing rate again by 24 months. Although overall results appeared to favor PTFE over UV, 62% of PTFE vs 16% of UV terminated at the above-knee level and the patency results of these two grafts were not significantly different at any level. The only other factor than graft type and distal anastomotic site that consistently correlated with late patency was tobacco use. Diabetic patients actually fared significantly better than nondiabetic patients, presumably because of the higher use of IS grafts and lower use of tobacco. The choice of graft overshadows all other factors affecting patency and its influence is magnified with more distal terminal anastomosis.

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mentioning

confidence: 99%

Factors affecting the patency of infrainguinal bypass

Rutherford¹,

Jones²,

Bergentz³

et al. 1988

Journal of Vascular Surgery

193

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show abstract

“…Several prospective, randomized clinical trials have shown the efficacy of umbilical vein grafts for femoropopliteal bypass. [10][11][12][13] A study by Johnson and Lee 14 from Boston showed that umbilical vein grafts had a patency of 70% at 2 years when used for above-knee femoral-popliteal bypass procedures. This was inferior to saphenous vein grafts but superior to polytetrafluoroethylene grafts.…”

Section: Discussionmentioning

confidence: 99%

The Utility of Recanalized Umbilical Vein Graft to the Hepato-pancreato-biliary Surgeon

et al. 2012

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“…ePTFE or Dacron) are the conduits of choice. However, for small diameter reconstructions, such prosthetic grafts have low cumulative patencies, ranging from 24 to 58% after 3 years [25,26] . These results have stimulated research in alternatives to prosthetic grafts such as preserved vascular allografts and xenografts, and the use of biomaterials to serve as a vascular tissue matrix [27,28] .…”

Section: Discussionmentioning

confidence: 99%

Glycerol-Preserved Arterial Allografts Evaluated in the Infrarenal Rat Aorta

Fahner

Idu²,

Gulik³

et al. 2008

Eur Surg Res

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Background: Vascular transplantation has become an alternative for prosthetic grafts. Suitable storage methods for vascular allografts are therefore necessary. For small caliber arterial allografts, cryopreservation and cold storage showed discouraging results. Since glycerol preservation proved effective for the storage of skin allografts, this preservation method was investigated for vascular allografts using a rat aortic transplantation model. Methods: Glycerol-preserved allografts (GA) were transplanted to the infrarenal aorta (n = 18) in Wistar rats. A control group (n = 18) underwent immediate autotransplantation (AU) of an equal length of aorta. Results: Cumulative graft patency at 90 days’ follow-up was 93% for AU and 78% for GA (ns). No aneurysm formation was detected in both groups. Intraluminal endothelial cell coverage, integrity of the media and smooth muscle cell repopulation were comparable in both groups. Intimal thickness was less in GA than in AU and inflammatory reaction in the adventitia was diminished in GA. Conclusion: GA were successfully grafted with acceptable patency rates compared to autografts, while intima hyperplasia and adventitial inflammatory reaction were less.

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Four years' results of a prospective, randomized clinical trial comparing polytetrafluoroethylene and modified human umbilical vein for below-knee femoropopliteal bypass

Cited by 63 publications

References 6 publications

Factors affecting the patency of infrainguinal bypass

Factors affecting the patency of infrainguinal bypass

The Utility of Recanalized Umbilical Vein Graft to the Hepato-pancreato-biliary Surgeon

Glycerol-Preserved Arterial Allografts Evaluated in the Infrarenal Rat Aorta

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