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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2002 June;21(2):145-51


lingua: Inglese

Prosthetic grafts for above-knee femoropopliteal bypass. A multicenter retrospective study of 564 grafts

Miyazaki K., Nishibe T., Sata F., Miyazaki Y. I., Kudo F. A., Flores J., Yasuda K.

Department of Cardiovascular Surgery, * Department of Public Health, Hokkaido University School of Medicine, Sapporo, Japan


Background. Many pros­thet­ic ­grafts includ­ing expand­ed poly­tet­ra­flu­o­roe­thy­lene (ePTFE) and poly­eth­y­lene tereph­thar­ate (Dacron) have recent­ly been used for above-knee femor­o­pop­li­teal ­bypass. The pur­pose of this study was to iden­ti­fy the fac­tors affect­ing paten­cy per­for­mance and ­patient sur­vi­val.
Methods. A mul­ti­cen­ter ret­ro­spec­tive anal­y­sis of 496 ­patients who ­received 564 ­grafts ­between 1990 and 1999 (325 ePTFE and 239 Dacron). Follow-up extend­ed to 114.5 ­months, with a mean of 30.8 ­months (±25.9 ­months).
Results. The over­all pri­mary paten­cy rate for all ­grafts was 71.4% at 5 years, 73.7% for ePTFE, and 68.9% for Dacron ­grafts. The sec­on­dary paten­cy rates at 5 years were 84.1% for ePTFE, and 83.8% for Dacron. No sig­nif­i­cant dif­fer­enc­es were found. The logis­tic regres­sion anal­y­sis ­revealed that young­er age at oper­a­tion and smok­ing his­to­ry were cor­re­lat­ed with ­decreased pri­mary paten­cy rate. The paten­cy rates were unaf­fect­ed by post­op­er­a­tive admin­is­tra­tion of oral anti­co­ag­u­lants or anti­plate­let ­agents, ­although phar­ma­co­ther­a­py con­trib­ut­ed to the improve­ment of sur­vi­val rates. Renal fail­ure, cere­bral infarc­tion and Dacron ­decreased sur­vi­val rate.
Conclusions. We con­clude that the paten­cy per­for­manc­es of pros­thet­ic ­grafts are sat­is­fy­ing. However, the ­choice of pros­thet­ic ­grafts for young­er ­patients or ­patients with a smok­ing his­to­ry need to be care­ful­ly con­sid­ered. Cerebral infarc­tion, chron­ic renal fail­ure and Dacron ­grafts may ­decrease the sur­vi­val rate. The oper­a­tive indi­ca­tions ­should be deter­mined care­ful­ly in these cases. The admin­is­tra­tion of ber­a­prost sodi­um is rec­om­mend­ed for post­op­er­a­tive phar­ma­co­ther­a­py.

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