COMPARISON OF CONDUITS FOR LEG REVASCULARIZATION

  • 1 January 1981
    • journal article
    • research article
    • Vol. 89  (1) , 8-15
Abstract
The saphenous vein (SV) remains the conduit of choice for lower limb revascularization. When SV is unavailable or unsuitable, 2 alternative conduits were employed: glutaraldehyde-stabilized human umbilical vein (HUV) and polytetrafluoroethylene (PTFE). In 218 patients who underwent lower limb revascularization, 3-yr patency of the 85 SV grafts was 75% compared to 34% for the 66 HUV grafts and 33% for the 67 PFTE grafts. Three factors independently influenced patency: the indication for surgery, the site of the distal anastomosis and the angiographic runoff. The SV group had significantly better patency than either HUV or PFTE in each of these subgroups. No consistent difference between HUV and PTFE was found. A risk score was obtained by assigning a value of 1-3 for each of the factors influencing patency-indication: 1 = claudication, 2 = rest pain, 3 = ischemic lesions; site: 1 = above knee (AK), 2 = below knee (BK), 3 = tibial; runoff: 1 = good (2 or 3 vessels), 2 = fair (1 vessel), 3 = poor (no vessel). Patients with the lowest risk scores (3-4) had the best 3-yr patency: SV, 78%; HUV, 44%; and PTFE, 48%. Patients with the highest risk scores (7 to 9) had the worst 3-yr patency: SV, 68%; HUV, 32%; and PTFE, 28%. SV had better patency under high- and low-risk conditions and remain the conduit of choice for lower limb revascularization. HUV and PTFE have equivalent and acceptable patency when SV is unavailable or unstable.