Below-knee popliteal and distal bypass with PTFE and vein cuff

Objectives: To determine the value of PTFE grafts with a distal vein cuff as a conduit for below-knee (BK) popliteal and distal bypass in the absence of autologous vein. Design: Retrospective study. Materials and methods: Forty below BK popliteal and distal bypass procedures in 39 patients with PTFE and distal vein cuff (Miller cuff n=31, Wolfe cuff and adjuvant arteriovenous fistula n=9). Nineteen primary and 21 secondary reconstruction procedures. Results: The primary patency rate was 62, 5% at 1 year falling to 50% at 2 years. The secondary patency rates were very similar owing to poor outcome of thrombectomy. Ten cases (25%) resulted in major amputation postoperatively. There was a tendency towards better outcome for primary procedures compared to secondary/redo procedures. Conclusions: BK popliteal and distal bypass with PTFE and distal vein cuff is a worthwhile procedure in the absence of autologous vein. The value of thrombectomy following thrombosis of a secondary bypass procedure with PTFE and distal vein cuff is questionable.