The aim of the study was to evaluate the immediate and long-term results of femoropopliteal
bypasses performed with a new bioactive heparin-treated expanded polytetrafluoroethylene
(ePTFE) graft in a single-center experience. From March 2002 to April 2006, 51 patients
underwent lower limb revascularization with a new bioactive ePTFE prosthetic graft
with covalent end-point attachment of heparin to the graft surface. Data concerning
preoperative assessment, intraoperative strategy, drug administration, and follow-up
surveillance program were prospectively collected in a dedicated database; early results
were analyzed in terms of graft patency, amputation rate, and deaths. Follow-up consisted
of clinical and duplex scan examination at 1, 6, and 12 months and yearly thereafter.
Midterm results in terms of primary and secondary patency, limb salvage, and survival
were analyzed. Patients were predominantly male (35 patients, 71%), with a mean age
of 71 years (SD = 9.05). Indications for surgical revascularization were critical
limb ischemia in 36 patients and severe intermittent claudication in 15 patients.
Interventions were performed for occlusion of a native vessel in 35 cases, whereas
12 patients had late thrombosis of a femoropopliteal bypass; the remaining four patients
were operated on for an occluded popliteal artery aneurysm. Intervention consisted
of below-knee bypass in 34 patients, while the other 17 had an above-knee revascularization.
No perioperative deaths occurred. Cumulative 30-day graft patency was 88%, with an
amputation rate of 4% (two cases). Results were similar in above- and below-knee revascularizatons.
Mean duration of follow-up was 18 months (SD = 7). Cumulative estimated 24-month survival
and primary patency rates were 97% and 80.2%, respectively; the corresponding limb
salvage rate was 85.7%. Long-term results did not significantly differ in above- and
below-knee revascularizatons. In our experience, the use of a modified ePTFE graft
with covalent end-point linkage of heparin molecules on the graft surface provides
good early and midterm results, with low rates of graft thrombosis and amputation.
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Article Info
Publication History
Published online: November 19, 2007
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© 2008 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
