Results of femoral-popliteal bypass above knee with synthetic graft

• Pogosian V.A.
• Chernyad’ev S.A.
• Fadin B.V.

Abstract

To date, with occlusions of the superficial femoral artery having a long length, the method of choice is femoral-popliteal bypass surgery. In the absence of an autovenous shunt, synthetic prostheses made of polytetrafluoroethylene (PTFE) are the most commonly used for bypass surgery. Accordingly, the aim of the study was to evaluate the results of femoral-popliteal bypass surgery performed for the first time using synthetic prostheses above the knee joint gap in patients with chronic lower limb ischemia.

Material and methods. A retrospective cohort study was conducted on the basis of the Sverdlovsk Regional Clinical Hospital No. 1 in Yekaterinburg, which included 92 patients who underwent reconstructive surgery in the vascular surgical department from 2016 to 2020 for chronic atherosclerotic occlusion of the superficial femoral artery. All patients underwent surgical treatment – femoral-popliteal bypass surgery with a synthetic prosthesis made of PTFE above the knee joint gap.

Results. In the immediate postoperative period, a significant increase in the ankle-shoulder index was noted. 24 months after the surgical treatment, the primary patency of the femoral-popliteal shunt was 55.4%. In the postoperative period, about 10% of limb amputations were performed at the level of the upper third of the thigh at different follow-up periods.

Conclusion. Performing femoral-popliteal bypass surgery above the knee joint gap using synthetic PTFE prostheses of 7 and 8 mm in size demonstrated high efficiency, a small number of postoperative complications, satisfactory primary patency of shunts 2 years after surgery, as well as a sufficiently high freedom from amputation.

Keywords:peripheral artery diseases; atherosclerosis; femoral-popliteal bypass surgery; synthetic prosthesis; polytetrafluoroethylene (PTFE)

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