Polytetrafluorethylene (PTFE) vs. Polyester (Dacron ® ) Grafts in Critical Limb Ischemia Salvage

Eliza Russu, Adrian Vasile Mureșan, Adrian Dumitru Ivănescu (), Réka Kaller (), Daniela Elena Nedelea, Raluca Niculescu, Bogdan Andrei Cordoș, Ovidiu Aurelian Budișcă (), Eliza Mihaela Arbănași and Emil Marian Arbănași
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Eliza Russu: Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania
Adrian Vasile Mureșan: Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania
Adrian Dumitru Ivănescu: Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Réka Kaller: Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania
Daniela Elena Nedelea: Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania
Raluca Niculescu: Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Bogdan Andrei Cordoș: Center for Advanced Medical and Pharmaceutical Research, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540139 Targu Mures, Romania
Ovidiu Aurelian Budișcă: Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Eliza Mihaela Arbănași: Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Emil Marian Arbănași: Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu Mures, Romania

IJERPH, 2023, vol. 20, issue 2, 1-13

Abstract: Background: Critical ischemia of the lower limbs refers to the last stages of peripheral arterial disease. It is characterized by resting discomfort or trophic disorders such as ulceration, skin necrosis, or gangrene in the lower limbs. Critical ischemia corresponds to Leriche–Fontaine (LF) stages III-IV and Rutherford stages 4–6. The purpose of this study was to observe the patency and postoperative complications of patients who have had infra-inguinal surgical revascularization and compare the results based on the kind of graft utilized. Methods: The present study was designed as an observational retrospective cohort study, including all patients from 2018 to 2019 diagnosed with severe ischemia of the lower limbs who were hospitalized at the Vascular Surgery Clinic of the County Emergency Clinical Hospital of Targu Mures. Results: Patients with a polytetrafluoroethylene (PTFE) graft had a higher incidence of chronic obstructive pulmonary disease ( p = 0.01), stage III LF (70.41% vs. 55.29%), p = 0.03), and a lower incidence of stage IV LF (29.95% vs. 44.71%, p = 0.03). As for complications, the PTFE group showed a lower incidence of bypass thrombosis (29.59% vs. 44.71%; p = 0.03) and graft infection (9.18% vs. 21.18%; p = 0.02), but no statistical significance in the event of bleeding ( p = 0.40). Regarding the outcomes, no statistical significance was seen for below-the-knee amputations or death. However, the PTFE group had a lower incidence of above-the-knee amputations (11.22% vs. 24.71%; p = 0.01). At multivariate analysis, the PTFE graft is an independent predictor of primary patency at 6, 12, and 24 months (OR: 2.15, p = 0.02; OR: 1.84, p = 0.04; and OR: 1.89, p = 0.03), as well as a protective factor against bypass thrombosis (OR: 0.52; p = 0.03), graft infection (OR: 0.37; p = 0.02), and above-the-knee amputation (OR: 0.38; p = 0.01).; Conclusions: According to this study’s findings, there were minor differences regarding the long-term patency, bypass thrombosis, graft infections, and above-the-knee amputations. In addition, the PTFE graft group had a higher incidence of primary patency at 6, 12, and 24 months, as well as a lower incidence of bypass thrombosis, graft infection, and above-the-knee amputations.

Keywords: polytetrafluoroethylene; polyester; vascular surgery; bypass; critical limb ischemia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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