Prosthetic above-knee femoropopliteal bypass grafting: Five-year results of a randomized trial

Abstract

Although the type of prosthetic used for above-knee femoropopliteal bypass grafts does not affect 5-year patency rates, age and graft size do influence results. These factors should be considered before a prosthetic bypass grafting procedure. Furthermore, these data should serve as a contemporary standard, with which evolving and conventional procedures can be compared.

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): Executive Summary

“…Four large, randomized, prospective studies summarized in Table 21 demonstrate findings consistent with the large body of evidence on the choice of graft material for the construction of bypasses to the above-knee popliteal artery (115)(116)(117)(118). The superior rates of immediate and long-term patency at all time periods favor use of autogenous vein, whether in situ or reversed.…”

“…Nearly all studies that have compared vein to prosthetic conduit for arterial reconstruction of the lower extremity have demonstrated the superior patency of vein (115)(116)(117)(118). In its absence, polytetrafluoroethylene or Dacron (polyester fiber) may be used with an expected lower but acceptable patency rate for above-knee bypasses.…”

Toward Engineering a Human Neoendothelium with Circulating Progenitor Cells

“…Prosthetic graft failure due to thrombus formation and/or neointimal hyperplasia is particularly prevalent in small-diameter (<6 mm) applications [28]. For example, when used for femoropopliteal bypass grafting, the 3-and 5-year patency rates are only 61% and 45%, respectively [29]. To address this problem, many approaches have been investigated to recreate the anti-thrombogenic characteristics of the vasculature.…”

Outcomes for Clinical Studies Assessing Drug and Revascularization Therapies for Claudication and Critical Limb Ischemia in Peripheral Artery Disease

“…[18][19][20][21][22][23][24][25][26][27][28][29][30] Studies of patients with critical limb ischemia using revascularization or angiogenesis trials focus on limb loss (amputation) and ulcer healing. [31][32][33] However, most percutaneous revascularization trials [34][35][36][37][38][39][40][41][42] but not all 38,[40][41][42] tend to focus on arterial patency and the need for repeat revascularization procedures. The inconsistency in outcomes between the various modes of treatment relates to the different treatment priorities in claudication compared with critical limb ischemia but may also reflect the different perspectives and priorities of those who manage PAD.…”