WHEN SHOULD PROSTHETIC GRAFTS BE USED AND CAN VEIN CUFFS OR OTHER ADJUNCTS IMPROVE PATENCY?

William M. Abbott

The issue as to whether there is a role for prosthetic grafts in surgery for occlusive disease of the lower extremity remains actively debated. It is generally agreed that synthetic grafts should only be used as a last resort for grafts crossing the knee joint. However, since the 1980s there has been considerable interest in the idea of preferentially using a prosthesis instead of saphenous vein for relatively short segment bypass grafts in the thigh from the common femoral artery to the above knee popliteal artery segment. Discussion of this subject has been ongoing for many years and yet a final resolution has not been achieved. The subject was again stimulated by a recent publication by the author regarding the choice of prosthesis for this purpose as a result of a multi-center randomized prospective trial [1] illustrating current results with prostheses in this location.

KEY WORDS: prosthetic graft, lower limbs artery occlusion, vein cuff.

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