Retrospective comparison of a heparin bonded ePTFE graft and saphenous vein for infragenicular bypass : implications for standard treatment protocol

Aim. The aim of our study is to assess the clinical effectiveness and therefore the medium-term patency of an ePTFE prosthesis treated with Carmeda BioActive Surface (CBAS) heparin technology. Methods. Fromjanuary 2003 to June 2005, 74 infragenicular femoral-popliteal grafts were carried out at our institution. All the patients were subjected to Doppler and color Doppler sonography peripheral angiography diagnostic procedures. Surgical procedures were performed on patients with complete occlusion of the femoral-popliteal axis and subgenicular rehabilitation of at least one vessel with acceptable flow, in advanced stage IIB (claudication, < 30 m walking distance), stage III (resting pain) and stage IV (trophic disorders) of Leriche-Fontaine classification. Follow-up was carried out through surgical and Doppler sonography examinations after 1 month, 3 months and then every 6 months throughout the course of the study. Results. Thirty-seven infragenicular bypass procedures using 6 mm ePTFE Propaten grafts and 37 procedures using devalvulated autologous saphenous veins were carried out. Conclusion. Based on the results obtained, we clearly cannot draw conclusions that are significant from a strictly statistical point of view, both because the study is retrospective and because, by making the population being analysed as homogenous as possible, a number of observations are excluded. However, we tried to draw conclusions that are acceptable from a clinical point of view. Above all, it is certain that should the autologous saphenous vein not be available, Propaten represents a very valid alternative prosthesis, as shown by the event free curve related graft thrombosis analysis of all the patients.