Early results of femoropopliteal bypass using a five millimeter "thin wall" polytetrafluoroethylene (Gore-Tex) prosthesis.

We report the early results of a series of 86 femoropopliteal bypass operations in which a 5 mm diameter thin wall polytetrafluoroethylene (Gore-Tex) prosthesis was used. Sixty-five bypasses were implanted in men and 21 in women. Thirty bypasses were done in conjunction with an aortic bifurcation graft and 18 patients had a bilateral procedure. The indication for operation was severe claudication in 74 cases and critical ischaemia in 12 cases. The angiographic run-off was good (three patent vessels) in 22 limbs and poor (one or two patent vessels) in 64 limbs. The cumulative patency rate for the whole group was 62% after 18 months. Angiographic run-off and the indication for operation were both found to influence cumulative patency rate significantly (p = 0.035 and p = 0.055, respectively). We also compared the results obtained when run-off was poor with equivalent data from our own previously published series in which a standard 6 mm diameter Gore-Tex prosthesis was used. This shows a difference in patency rate, for example 57% against 37% after 18 months, in favour of the smaller bore thin wall graft.