Femoropopliteal Bypass With Either Adequate Ipsilateral Reversed Saphenous Vein or Obligatory Polytetrafluoroethylene

The results are presented of a 10-year experience with 312 femoropopliteal bypasses performed in 285 patients using ipsilateral autologous reversed greater saphenous vein when available and adequate and polytetrafluoroethylene (PTFE) when not. The indications for operation were severe claudication in 121 (39%), rest pain in 95 (30%), and minor tissue loss in 96 (31%) limbs. There were 235 (75%) saphenous vein bypasses, of which 157 were above and 78 below the knee, and 77 (25%) PTFE bypasses, 58 above and 19 below the knee. Of these, 232 (79%) saphenous vein and 62 (21%) PTFE bypasses were primary procedures. The 30-day mortality rate was 3% (7/285) and the 30-day amputation rate was 2% (6/312). Overall, 24 (10%) saphenous vein and 30 (39%) PTFE grafts ultimately failed. The cumulative primary patency of all bypasses was 77% ± 4% (mean ± 1 SE) (85% to 69%, 95% confidence interval) at 3 years and 75% ± 4% (86% to 64%) at 5 years. Saphenous vein primary patency was superior to that of PTFE at 3 years, 87% ± 4% (97% to 77%) vs. 54% ± 12% (65% to 41%), ( p