Lower limb revascularization for PAD using a heparin-coated PTFE conduit

Objective: To assess the patency of the PROPATEN Graft in lower extremity bypasses. Methods: We retrospectively reviewed all lower extremity bypasses with the PROPATEN Graft from 2007-2009 at a single institution. There were 68 implants-56% male; mean age 69. Comorbidities included hypertension (HTN; 81%), hyperlipidemia (72%), coronary artery disease (CAD; 74%), and smoking (59%). Most patients were Rutherford category 4 or higher. A total of 34% of patients had only 1 runoff vessel; 10% of patients required a complex concomitant procedure with sequential extremity revascularization. Statistics were via Kaplan Meier. Results: Mean follow-up was10.4±8.0 months (0-30). Patency was excellent in all positions. Primary patency for all patients was 94.0% and 86.0% at 30 days and 18 months, respectively. Limb salvage at 30 days was 95%, and at 18 months was 90%. No patients developed HIT. Ten patients lost graft patency. These patients had severe Peripheral Vascular Disease (PVD), with rest pain or tissue loss, poor runoff (no runoff or single vessel runoff), compromised inflow, and restored competitive flow. Fifty percent of the failed grafts were in the infrapopliteal position. Endovascular intervention and graft thrombectomy to restore patency was attempted in 2 patients and was unsuccessful. Conclusion: The GORE PROPATEN Vascular Graft demonstrates excellent patency in all arterial positions and may be the conduit of choice for all prosthetic bypasses.