Long-Term Outcomes of a Japanese Prospective Multicenter Registry Using a Heparin-Bonded Expanded Polytetrafluoroethylene Graft for Above-the-Knee Femoropopliteal Bypasses
-
- Fujimura Naoki
- Department of Vascular Surgery, Saiseikai Central Hospital
-
- Obara Hideaki
- Department of Surgery, Keio University School of Medicine
-
- Matsubara Kentaro
- Department of Surgery, Keio University School of Medicine
-
- Toya Naoki
- Department of Surgery, The Jikei University Kashiwa Hospital
-
- Isogai Naoko
- Department of Surgery, Shonan Kamakura General Hospital
-
- Ogino Hidemitsu
- Department of Surgery, Narita Tomisato Tokushukai Hospital
-
- Fujii Taku
- Department of Surgery, Saitama Municipal Hospital
-
- Kudo Toshifumi
- Department of Surgery, Tokyo Medical and Dental University
-
- Kanaoka Yuji
- Department of Cardiovascular Surgery, Kawasaki Medical School
-
- Harada Hirohisa
- Department of Vascular Surgery, Saiseikai Central Hospital
-
- Uchiyama Hidetoshi
- Department of Vascular Surgery, Tsuchiura Kyodo General Hospital
-
- Guntani Atsushi
- Department of Vascular Surgery, Saiseikai Yahata General Hospital
-
- Shimogawara Tatsuya
- Department of Vascular Surgery, Saisekai Yokohamashi Tobu Hospital
-
- Watada Susumu
- Department of Surgery, Kawasaki Municipal Hospital
-
- Shibutani Shintaro
- Kawasaki Tsurumi Vascular Surgery Clinic
-
- Ohki Takao
- Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine
抄録
<p>Background: Despite the widespread use of PROPATEN®, a bioactive heparin-bonded expanded polytetrafluoroethylene graft, in bypass surgery, there are only a few reports of long-term results. We evaluated the long-term results of PROPATEN®use for above-knee femoropopliteal bypass (AKFPB).</p><p>Methods and Results: After PROPATEN®-based AKFPB, patients were prospectively registered at 20 Japanese institutions between July 2014 and October 2017 to evaluate long-term results. During the median follow-up of 76 months (interquartile range 36–88 months) for 120 limbs (in 113 patients; mean [±SD] age 72.7±8.1 years; 66.7% male; ankle-brachial index [ABI] 0.45±0.27; lesion length 26.2±5.7 cm; chronic limb-threatening ischemia in 45 limbs), there were 8 major amputations; however, clinical improvement was sustained (mean [±SD] ABI 0.87±0.23) and the Rutherford classification grade improved in 105 (87.5%) limbs at the latest follow-up. At 8 years, the primary patency, freedom from target-lesion revascularization, secondary patency, survival, and amputation-free survival, as estimated by the Kaplan-Meier method, were 66.3±4.8%, 71.5±4.4%, 86.5±3.4%, 53.1±5.0%, and 47.4±5.3%, respectively.</p><p>Conclusions: This multicenter prospective registry-based analysis showed sustained excellent clinical improvement and secondary patency for up to 8 years following PROPATEN®-based AKFPB. PROPATEN®constitutes a durable and good revascularization option for complex superficial femoral artery lesions, especially when endovascular treatment is inappropriate or an adequate venous conduit is unavailable.</p>
収録刊行物
-
- Circulation Journal
-
Circulation Journal advpub (0), 2024-04-12
一般社団法人 日本循環器学会