Original communication| Volume 87, ISSUE 5, P581-587, May 1980

Management of early and late thrombosis of expanded polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts: Favorable prognosis with appropriate reoperation

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      In a series of 175 polytetrafluoroethylene (PTFE) femoropopliteal bypasses for limb salvage, nine thrombosed within the first month after operation and 22 thrombosed from 1 to 23 months after operation. With reoperation (four simple thrombectomies and five graft extensions) all nine early closures are patent 3 to 27 months (mean, 16 months) later. Four of the late thromboses did not jeopardize the limb, and viability has persisted 4 to 14 months. Eighteen of the late thromboses placed the limb in jeopardy. Appropriate reoperation after preoperative angiography restored graft patency for 2 to 27 months in 14 of 18 cases. Six grafts were patent more than 1 year after reoperation. The operations performed for late thrombosis were incision and patch angioplasty for intimal hyperplasia (25%), graft extension for distal disease (42%), and simple thrombectomy when no cause of thrombosis was identified (33%). These findings justify an aggressive approach with appropriate reoperations when PTFE femoropopliteal bypasses thrombose in the early or late postoperative period. Important additional limb salvage can thereby be obtained.
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