Rashid Usman, Muhammad Jamil.
Patency of Autologous Reverse Great Saphenous Vein Versus Polytetrafluroethylene in Below Knee Femoro popliteal Bypass Grafting.
J Surg Pak Nov ;21(1):2-8.

Objective: To compare the patency rates of autologous saphenous vein and expanded polytetrafluroethylene graft in femoropopliteal below knee bypass grafting in patients with peripheral vascular disease. Study design: Comparative study. Place & Duration of study: Department of Vascular Surgery Combined Military Hospital Lahore, from January 2011 to January 2013. Methodology: Patients with disabling intermittent claudication, rest pain, impending gangrene were included. All patient had duplex scan of the affected limb to assess the velocity of the blood flow in infrainguinal vessels as well as. CTA from infra-renal aorta onwards distally. At operation popliteal artery was assessed for patency and runoff. Great saphenous vein was also assessed for diameter (at least 4mm was labeled as suitable). In non suitable cases PTFE was used. Results: A total of 200 bypasses were performed in 190 patients. Of these, 102 (51%) patients had reverse saphenous vein bypass (RSVB) graft and 98 (49%) received expanded polytetrafluroethylene (e-PTFE) graft. Common indications of operation were intermittent claudication in 101 (50.5%) and rest pain in 70 (35%) patients. At 3 year post surgery seven (3.7%) patients were lost to follow-up and 36 (19%) died. Primary patency rate for e-PTFE graft was 62.9% while it was 86.4% for RSVB graft (p =0.032). The secondary patency rate in e-PTFE graft was 64.1% and in RSVB graft 85.1% (P = 0.034). Conclusion: Saphenous vein graft had a superior patency rates at all intervals of time and it needed lesser redo operations when compared with e-PTFE graft.

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