Open AccessRandomized clinical trial of distal anastomotic interposition vein cuff in infrainguinal polytetrafluoroethylene bypass grafting
Author(s) -
Griffiths G. D.,
Nagy J.,
Black D.,
Stonebridge P. A.
Publication year - 2004
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.4501
Subject(s) - medicine , surgery , anastomosis , cuff , bypass grafting , polytetrafluoroethylene , randomized controlled trial , vein , grafting , artery , chemistry , materials science , organic chemistry , metallurgy , polymer
Abstract Background: The aim was to examine the effect of a Miller vein cuff at the distal anastomosis on the medium‐ to long‐term patency and limb salvage rates of femoral to above‐knee and femoral to below‐knee popliteal artery polytetrafluoroethylene (PTFE) bypasses. Methods: This study involved extended follow‐up of the original cohort of patients included in a previously reported multicentre randomized clinical study. Outcome measures were bypass graft patency and limb salvage. Results: Two hundred and sixty‐one bypass operations were originally randomized. For this study, full data were available on 235 (120 with a Miller cuff, 115 without). The cumulative 5‐year patency rate for above‐knee bypasses with a Miller cuff was 40 per cent, compared with 42 per cent for non‐cuffed bypasses ( P = 0·702). The cumulative 3‐year patency rate for below‐knee bypasses with a Miller cuff was 45 per cent, compared with 19 per cent for non‐cuffed bypasses ( P = 0·018). A Miller cuff had no significant effect on limb salvage for above‐knee or below‐knee bypasses. Conclusion: Three‐year patency rates of femoral to below‐knee popliteal PTFE bypasses were improved by a Miller cuff. Miller cuffs had no effect on patency rates for femoral to above‐knee popliteal bypasses at 5 years and did not improve limb salvage in either group. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.