The Scandinavian Propaten® Trial – 1-Year Patency of PTFE Vascular Prostheses with Heparin-Bonded Luminal Surfaces Compared to Ordinary Pure PTFE Vascular Prostheses – A Randomised Clinical Controlled Multi-centre Trial

Abstract

Introduction: Is it possible by pharmacological methods to attenuate the expansion rate of abdominal aortic aneurysms?Method: An Internet-based systematic literature search was performed to identify published reports on pharmacological methods to influence aneurysmal expansion rate.Results: Of an original 450 articles, 22 remained to review: they included 15 cohort studies with 12,321 patients and seven randomised clinical trials (RCTs) with 1546 patients. Most studies are performed without a pre-study sample size calculation. There is no consistent pattern of pharmacological influence on expansion rate, but statins, non-steroidal anti-inflammatory drugs (NSAIDs) and macrolides should be further evaluated.Conclusion: Properly designed RCTs are needed before conclusions can be drawn on the possibility to pharmacologically attenuate aneurysmal expansion and prevent rupture.

Bypass Surgery in Limb Salvage: Polytetrafluoroethylene Prosthetic Bypass

“…13 overall, primary patency after 1 year was 86.4% for hb-PtFe grafts and 79.9% for PtFe grafts. secondary patency was 88% in the hb-PtFe graft group and 81% in the other.…”

Five-year outcomes following a randomized trial of femorofemoral and femoropopliteal bypass grafting with heparin-bonded or standard polytetrafluoroethylene grafts

“…Patients were considered for recruitment if they required a femorofemoral bypass graft or a prosthetic femoropopliteal bypass graft as determined by angiography and lack of availability of a venous conduit. Details of the trial have been published previously. Briefly, the primary endpoint was primary patency at 1‐year follow‐up, and patients were recruited and randomized in a ratio of 1 : 1, stratified by centre, to either a Hb‐PTFE (Propaten®) or a standard PTFE graft from the same manufacturer (W. L. Gore & Associates, Flagstaff, Arizona, USA).…”

“…The primary outcome of the randomized trial was graft patency at 12 months, as reported previously. The principal longer‐term outcome was graft patency at 5 years.…”

“…A small prospective observational study suggested similar effects for long‐term subcutaneous heparin application and heparin‐bound polyethylene terephthalate prostheses. Consequently, an RCT of heparin‐bonded PTFE (Hb‐PTFE) versus standard PTFE grafts was undertaken using grafts from the same manufacturer. The 1‐year results demonstrated superior patency rates for the population receiving the Hb‐PTFE graft.…”

Evidenzbasierte Gefäßchirurgie

“…Nach 1 Jahr waren die primären und sekundären Offenheitsraten in der Gruppe der verstärkten Prothesen signifikant besser (55 % und 58 % vs. 42 % und 47 %), für den Extremitätenerhalt ergaben sich jedoch keine signifikanten Unterschiede (nach 1 Jahr 75 % mit und 69 % ohne Support). In der skandinavischen randomisierten Propaten ® -Studie (Lindholt et al 2011) schließlich wurden heparingebundene PTFE-Prothesen mit gewöhnlichen PTFE-Prothesen verglichen. Die Bypässe wurden an die tibialen Gefäße angeschlossen und die Heparin-PTFE-Prothesen über einen autologen Venenpatch distal anastomosiert.…”