Best material for below inguinal arterial graft.
|A||Saphenous upside down|
a. Vein Graft-gives the best results- either the vein is reversed or valves destroyed by a valvulotome.
b. PTFE Graft-many surgeons construct the lower anastomosis using a small collar of vein between the PTFE and the recipient artery.
c. Prosthetic material-Favoured material is the DACRON- Woven and Knitted( Woven better)
d. Results are best with good calibre vessels and they decrease as we go down in the limb.
e. Long term results of Aortoiliac reconstructive surgery are good. Femoropopliteal surgery is less successful.
f. Immediate postop success rate for vein bypass exceeds 90%, but many cases fail in the first 18 months and at 5 years success is 50-60%.
g. With PTFE- 5 year success is less than 50%.