The authors report their experience of 67 consecutive patients submitted to reconstruction of the below-the-knee arteries by means of expanded PTFE (Gore-Tex) prostheses.
Results in terms of patency and limb salvage are not of absolute value owing to the lack of selection of patients, most of whom were at very high risk. However, a lower performance in comparison to autologous vein graft was evident.
A pathologic study of patent, occluded and infected grafts is presented: the high level of "biocompatibility" of such grafts is confirmed.
A high incidence of infection both of patent and occluded grafts was a relevant feature of the casuistic.
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References
1.
Campbell CD, Brooks DH, Webster MW, Bahnson HT: The use of expanded microporous polytetrafluoroethylene for limb salvage: A preliminary report. Surg79:485, 1976.
2.
Burnham SJ, Flanigan DP, Goodreau JJ, et al: Nonvein bypass in below-knee reoperation for lower limb ischemia . Surg84:417, 1978.
3.
Campbell CD, Brooks DH, Siewers RD, et al: Extra-anatomic by-pass with expanded polytetrafluoroethylene . Surg Gynec Obstet148:525, 1979.
4.
Summary of clinical results across entire vascular data base. Newark, W.L.Gore & Ass Inc, July 31, 1980.
5.
Mehta S.: A statistical summary of the results of femoro-popliteal bypass surgery. Published and/or presented during 1965 to 1979. Newark, W.L. Gore & Ass Inc, Nov 1980.
6.
Gautier R., Quesada C., Guidicelli H., et al: Bilan de 18 mois d'utilisation des prothèses Gore-Tex en chirurgie vasculaire. A propos de 110 implantations. Chirurgie104:339, 1978.
7.
Suy R., Nevelteen A., Deleersnijder D., et al: The expanded polytetrafluoroethylene (PTFE) graft as a vascular substitute. J Cardiovasc Surg21:321, 1980.
8.
Darling RC: Invited commentary to the paper of Raithel D and Groitl H. World J Surg4:223, 1980.
9.
Johnson WC: Preliminary experience with expanded polytetrafluoroethylene grafts. Surg85:123, 1979.
10.
Clyne Cac, McVeigh JA, Fox MJ, et al: PTFE (Goretex) femoropopliteal reconstruction for limb salvage . Ann Roy Coll Surg Engl61:301, 1979.
11.
Cutler SJ, Ederer F.: Maximum utilization of the life table method in analyzing survival. J Chron Dis8:699, 1958.
12.
Hamlin GW, Rajah SM, Crow MJ, Kester RC: Evaluation of the thrombogenic potential of three types of arterial graft studied in an artificial circulation. Br J Surg65:272, 1978.
13.
Shack RB, Neblett WW, Richie RE, Dean RH: Expanded polytetrafluoroethylene as dialysis access grafts: Serial study of histology and fibrinolytic activity. Amer Surg43:817, 1977.
14.
Kenny DA, Berger K., Walker MW, et al: Experimental comparison of the thrombogenicity of fibrin and PTFE flow surfaces. Ann Surg191:355, 1980.
15.
Kempczinski RF: Physical characteristics of implanted polytetrafluoroethylene grafts. A preliminary report. Arch Surg114:917, 1979.
16.
Cavallaro A. , Sciacca V., Alessandrini A., Garofalo M.: PTFE prostheses in femoro-tibial reconstructions. Proc XII World CongrAngiology, Athens , September 7-12, 1980 (In press).
17.
Raithel D., Groitl H.: Small artery reconstruction with a new vascular prosthesis. World J Surg4:223, 1980.
18.
Echave V., Koornick AR, Haimov M., Jacobson JH II: Intimal hyperplasia as a complication of the use of the polytetrafluoroethylene graft for femoro-popliteal bypass. Surg86:791, 1979.
19.
Baker LD Jr, Johnson JM, Goldfarb D.: Expanded polytetrafluoroethylene (PTFE) subcutaneous arteriovenous conduit: An improved vascular access for chronic hemodialysis. Trans ASAIO22:382, 1976.
20.
Stipa S., Cavallaro A., Alessandrini A., et al: Femoro-tibial by-pass grafts with reversed autologous saphenous vein: Experience in 61 consecutive patients. In: Peripheral Arterial Disease: Medical and Surgical Problems, ed. by Stipa S, Cavallaro A.London, Acad Press, 1982, Reg. 223
21.
Hastings OM , Jain KH, Hobson RW II, Swan KG: A prospective randomized study of three expanded polytetrafluoroethylene (PTFE) grafts as small arterial substitutes. Ann Surg188:743, 1978.
22.
Haimov M., Giron F., Jacobson JH II: The expanded polytetrafluoroethylene graft. Three years' experience with 362 grafts. Arch Surg114:673, 1979.
23.
Thompson JE , Garrett WV: The role of polytetrafluoroethylene grafts in vascular surgery. Surg85:601, 1979.
24.
Rosenberg IL : PTFE (Goretex) grafts for limb salvage (Correspondence) . Ann Roy Coll Surg Engl62:76, 1980.
