Revascularization of the Femoropopliteal Arteries Using Saphenous Vein, Polytetrafluoroethylene, and Umbilical Vein Grafts

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Abstract
• Saphenous vein (SV), polytetrafluoroethylene (PTFE), and umbilical vein (UV) grafts placed in the femoropopliteal or tibial areas for occlusive arterial disease were compared for the years between 1975 and 1982. In proximal v distal popliteal placement, the early failure rate differed only in PTFE grafts to relieve ischemia, with below-knee failure being worse. In all femoropopliteal grafts for claudication, the SV were better than the UV grafts. When done for ischemia, the SV were better than the PTFE grafts. By life-table analysis, SV grafts done for claudication or for ischemia were superior to PTFE grafts. The UV grafts also were better than PTFE grafts. Arteriography showed marked aneurysmal dilatation in a UV graft in the common femoral to popliteal to anterior tibial area at 50 months. In a second patient, mild aneurysmal dilatation was seen. The UV graft is acceptable when SV is not available. The PTFE graft across the knee gives poor results but above the knee is comparable with UV grafts. (Arch Surg 1982;117:1543-1550)

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