Advertisement
Surgery
Advanced searchSave search
Original communication| Volume 79, ISSUE 5, P485-491, May 1976

The use of expanded microporous polytetrafluoroethylene for limb salvage: A preliminary report

DOI:https://doi.org/10.5555/uri:pii:0039606076903524
The use of expanded microporous polytetrafluoroethylene for limb salvage: A preliminary report
Next ArticleAddendum Aneurysm formation in expanded polytetrafluoroethylene prostheses
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Initial laboratory and clinical evaluation of a new prosthetic material, expanded microporous polytetraf uoroethylene (PTFE), for small vessel replacement is promising and encourages further clinical trial. Frequently the autogenous saphenous vein is not available for bypass procedures, and alternative arterial substitutes have not proved reliable for replacement of small vessels. In this study, IS patients with impending loss of limb and no available saphenous vein underwent revascularization of the lower extremity with expanded microporous PTFE grafts. Thirteen of 15 patients now demonstrate viable extremities with a resulting over-all early patency and limb salvage rate of 87 percent for this series. Follow-up ranges from one to 8 months. Seven patients had diabetes mellitus and eight had atherosclerotic heart disease. Nine grafts crossed the knee joint. In all patients arterial runoff was poor. Six patients had previous femoropopliteal bypasses, five with autogenous veins and one with Dacron velour. Two patients had multiple previous operations that failed, first with autogenous vein and later with fabric grafts. The current limb salvage and patency rate of 87 percent in high-risk patients suggests that expanded PTFE may be the prosthesis of choice when an autogenous vein is not available and possibly an equally good substitute when the venous autograft is available.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Campbell C.D.
        • Goldfarb D.
        • Roe R.
        A small arterial substitute: Expanded microporous polytetrafluoroethylene: Patency versus porosity.
        Ann. Surg. 1975; 182: 138
        • Campbell C.D.
        • Goldfarb D.
        • Detton D.D.
        • et al.
        Expanded polytetrafluoroethylene as a small artery substitute.
        Trans. Am. Soc. Artif. Intern. Organs. 1974; 20: 86
        • Crawford E.S.
        • De Bakey M.E.
        • Morris Jr, G.C.
        • et al.
        Evaluation of late failures after reconstructive operations for occlusive lesions of the aorta and iliac, femoral, and popliteal arteries.
        Surgery. 1960; 47: 79
        • Cutler B.S.
        • Thompson J.E.
        • Patman R.D.
        • et al.
        The modified bovine arterial graft: A clinical study.
        Surgery. 1974; 76: 963
        • Dale W.A.
        Salvage of arteriosclerotic legs by vascular repair.
        Ann. Surg. 1967; 165: 844
        • Dale W.A.
        • Lewis M.R.
        Modified bovine heterografts for arterial replacement.
        Ann. Surg. 1969; 169: 927
        • Darling R.C.
        • Linton R.R.
        • Razzuk M.A.
        Saphenous vein bypass grafts for femoropopliteal occlusive disease: A reappraisal.
        Surgery. 1967; 61: 31
        • DeLaurentis D.A.
        • Friedman P.
        Sequential femoropopliteal bypasses: Another approach to the inadequate saphenous vein problem.
        Surgery. 1972; 71: 400
        • Deterling Jr, R.A.
        • Coleman Jr, C.C.
        • Parshley M.S.
        Experimental studies of the frozen homologous aortic graft.
        Surgery. 1951; 29: 419
        • DeWeese J.A.
        • Rob C.G.
        Autogenous venous bypass grafts five years later.
        Ann. Surg. 1971; 174: 346
        • Edwards W.S.
        Present status of femoropopliteal arterial reconstruction.
        Ann. Surg. 1968; 168: 1094
        • Fujiwara Y.
        • Cohn L.H.
        • Adams D.
        • et al.
        Use of Gore-Tex grafts for replacement of the superior and inferior venae cavae.
        J. Thorac. Cardiovasc. Surg. 1974; 67: 774
        • Goyanes J.
        Neuvos trabajos de chirurgia vascular: Substitution plastica de los arterias por los venas o arterioplastica venosa, aplicado, comoneuvo metodo, al traitamiente de los aneurismos.
        El Siglo Med. 1906; 53: 561
        • Gross R.E.
        • Bill Jr, A.H.
        • Pierce E.C.
        Methods for preservation and transplantation of arterial grafts.
        Surg. Gynecol. Obstet. 1949; 88: 689
        • Hufnagel C.A.
        Resection and grafting of the thoracic aorta with minimal interruption of the circulation.
        in: presented at Forum on Fundamental Surgical Problems. American College of Surgeons, Los Angeles1948
        • Kakkor V.V.
        The cephalic vein as a peripheral vascular graft.
        Surg. Gynecol. Obstet. 1969; 128: 551
        • Keshishian J.M.
        • Smyth N.P.D.
        • Adkins P.C.
        • et al.
        Clinical experiences with the modified bovine arterial heterograft.
        Ann. Surg. 1970; 172: 690
        • Koontz T.J.
        • Stansel H.C.
        Factors influencing patency of the autogenous vein femoropopliteal bypass graft: An analysis of 74 cases.
        Surgery. 1972; 71: 753
        • Kunlin J.
        Le traitement de lischemie arteriticlue par la greffe veinruse longue.
        Rev. Chir. Paris. 1951; 70: 206
        • Lexer E.
        Die ideale operation des arteriellen and des arteriellevenoser aneurysma.
        Arch. Klin. Chir. 1907; 83: 458
        • Linton R.R.
        • Wirthlin L.S.
        Femoropopliteal composite dacron and autogenous vein bypass grafts. A preliminary report.
        Arch. Surg. 1973; 107: 748
        • Matsumoto H.
        • Hasegawa T.
        • Fuse K.
        • et al.
        A new vascular prosthesis for a small caliber surgery.
        Surgery. 1973; 74: 519
        • Norton L.
        • Eiseman B.
        Replacement of portal vein during panereatectomy for carcinoma.
        Surgery. 1975; 77: 280
        • Ochsner J.L.
        • DeCamp P.T.
        • Leonard G.L.
        Experience with fresh venous allografts as an arterial substitute.
        Ann. Surg. 1971; 173: 933
        • Parsonnet V.
        • Alpert J.
        • Brief T.K.
        Autogenous polypropylene-supported collagen tubes for long-term arterial replacement.
        Surgery. 1971; 70: 935
        • Ray F.S.
        • Lape C.P.
        • Lutes C.A.
        • et al.
        Femoropopliteal saphenous vein bypass grafts. Analysis of 150 cases.
        Am. J. Surg. 1970; 119: 385
        • Reichle F.A.
        • Tyson R.R.
        Bypasses to tibial or popliteal arteries in patients.
        Ann. Surg. 1972; 176: 315
        • Rosenberg N.
        • Lord G.H.
        • Henderson J.
        • et al.
        Collagen arterial graft of bovine origin: Seven year observation in the dog.
        Surgery. 1970; 67: 951
        • Smith D.E.
        • Hammon J.
        • Anane-Sefah J.
        • et al.
        Segmental venous replacement. A comparison of biological and synthetic substitutes.
        J. Thorac. Cardiovasc. Surg. 1975; 69: 589
        • Soyer T.
        • Lempinen M.
        • Cooper P.
        • et al.
        A new venous prosthesis.
        Surgery. 1972; 72: 864
        • Sparks C.H.
        Die-grown reinforced arterial grafts: Observations on long-term animal grafts and clinical experience.
        Ann. Surg. 1970; 172: 787
        • Sparks C.H.
        Silicone mandril method for growing reinforced autogenous femoropopliteal artery grafts in situ.
        Ann. Surg. 1973; 177: 293
        • Stipa S.
        The cephalic and basilic veins in peripheral arterial reconstructive surgery.
        Ann. Surg. 1972; 175: 581
        • Stoney R.J.
        • James D.R.
        • Wylie E.J.
        Surgery for femoropopliteal atherosclerosis.
        Arch. Surg. 1971; 103: 548
        • Szilagyi D.E.
        Some controversial topics in vascular surgery.
        Am. J. Surg. 1969; 118: 406
        • Szilagyi D.E.
        • Smith R.F.
        • Elliott J.P.
        • et al.
        Long-term behavior of a Dacron arterial substitute: Clinical, roentgenologic and histologic correlations.
        Ann. Surg. 1965; 162: 453
        • Tice D.A.
        • Zerbino V.
        Clinical experience with preserved human allografts for vascular reconstruction.
        Surgery. 1972; 72: 260
        • Tyson R.R.
        • Reichle F.A.
        Femoro-tibial bypass for salvage of the ischemic lower extremity.
        Surg. Gynecol. Obstet. 1972; 134: 771
        • Volder J.G.R.
        • Kolff W.J.
        Induced growth of connective tissue in cardiovascular prostheses.
        Trans. Am. Soc. Artif. Intern. Organs. 1974; 20: 521
        • Volder J.G.R.
        • Kirkham R.H.
        • Kolff W.J.
        A-V shunts created in new ways.
        Trans. Am. Soc. Artif. Intern. Organs. 1973; 19: 38

      Article info

      Publication history

      Accepted: September 5, 1975

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606076903524

      Copyright

      © 1976 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX