Femoral to Above Knee Popliteal Prosthetic Bypass

Abstract

Various choices are available when selecting a prosthetic bypass to the above knee popliteal artery. The choices include the material, the size and the external support. Whether to use polytetrafluoroethylene (PTFE), polyester graft or human umbilical vein is a matter of surgeon’s preference since none of these grafts has been proven to offer a significant patency advantage over the other. However, the use of larger diameter grafts (8 mm) has been shown to be associated with better patency rates than smaller diameter grafts. Although there is no strong evidence to support using externally supported grafts to the above knee popliteal artery, our preference has been to use 8-mm PTFE ringed grafts to decrease the possibility of kinking during tunneling. Newer PTFE grafts with various features such as carbon lining or heparin coated and specially designed cuffs continue to be introduced into the market. Whether they will provide better patency rates is yet to be proven.