The limitations of polytetrafluoroethylene in the reconstruction of femoropopliteal and tibial arteries.

During a three year period, 100 patients underwent femoropopliteal or tibial polytetrafluoroethylene bypass grafts. The indication for operation was limb salvage in 75 patients. Limb salvage was achieved in 63 of 75 patients. The patency rate at 30 months for those with above-knee grafts was superior to that for those with below-knee bypasses. Grafts done in good runoff situations resulted in better patency rates than bypasses in poor outflow situations. Our results suggest that reinforced expanded polytetrafluoroethylene grafts appear to be acceptable substitutes for limb salvage when a vein is not available. However, autogenous vein bypass grafting remains our preferred method of femoropopliteal and tibial reconstruction, especially when the distal anastomosis must be constructed below the knee. Whether or not polytetrafluoroethylene is better than other current graft materials is still not known.