Occluded Infrainguinal Vein Bypass Grafts. Are Secondary Alloplastic Procedures Worthwhile?

Abstract

Occlusion of an infrainguinal saphenous vein bypass presents an unresolved problem of further treatment in patients with threatened limbs. The implantation of alloplastic grafts is an attempt to possibly avoid amputation. The authors report 56 patients who were treated by secondary alloplastic grafts after occlusion of their vein bypass. All secondary procedures were performed for limb salvage. The median time of patency of sequential combined saphenous vein plus an additional alloplastic bypass was sixteen months. Following a reocclusion of the secondary grafts, 45 % required major amputation. Nevertheless, the median period of limb salvage was fifty-four months. Therefore, secondary alloplastic grafts seem to be a reasonable procedure in the treatment of threatened limbs after occlusion of an infraginguinal saphenous vein bypass, if one takes the limited life expectancy of sixty-four months into account for these patients.