Infrainguinal Polytetrafluoroethylene Grafts: Saved Limbs or Wasted Effort? A Report on Ten Years' Experience

Two-hundred and twenty-four infrainguinal polytetrafluoroethylene reconstructions were performed for critical ischemia over a 10 year period: 48 to the above-knee popliteal artery, 113 to the below-knee popliteal artery, and 63 to the tibial vessels. The cumulative patency rates were 84±6% and 63±9% for above-knee popliteal, 53±5% and 35±7% for below-knee popliteal, 45±6% and 30±9% for tibial vessels at one and five years respectively. Limb salvage rates were 81±6% and 73±9% (above-knee popliteal), 69±5% and 57±9% (below-knee popliteal), 64±7% and 32±10% (tibial vessels) at one and five years respectively. Graft occlusion did not result in limb loss in 32 cases. Preoperatively, 54% of the patients had limited mobility while 43% were regarded as severely restricted. At follow-up, 57% of the patients were considered to be independent, 26% had limited mobility, and 17% were still severely restricted. Polytetrafluoroethylene provides good short-term limb salvage and improved mobility in patients with critical ischemia and poor life expectancy. Its use is well worth the effort.