The fate of bypass grafts to an isolated popliteal artery segment.

From 1967 to 1982, 55 patients underwent 64 femoropopliteal bypass grafts into an isolated popliteal artery segment. Seventy-six percent of these patients had threatened limb loss from advanced atherosclerosis, and 24% had disabling claudication. Forty-five percent of the patients were diabetic. The 30-day operative mortality rate was 1.6%, and the 30-day postoperative amputation rate was 3.2%. Graft potencies were analyzed by the life table method. The 2-year graft patency rate was 70.6%, and the 5-year patency was 60.7%. The 2- and 5-year limb salvage rates were each 83%. With evidence for decreased graft function, four grafts (6%) were successfully revised before failure occurred. Among 10 polytetrafluoroethylene grafts followed up to a maximum of 48 months, there was one early postoperative occlusion, one long-term occlusion, and one early amputation. With respect to patency and limb salvage, the results of isolated popliteal artery segment grafts fall between the 5-year patency and limb salvage rates for autogenous vein grafts to popliteal arteries with at least one tibial vessel runoff (78% patency and 89% limb salvage) and the rates for femoral-tibial/peroneal grafts (5-year patency 56%, limb salvage 69%). An isolated segment is an appropriate recipient vessel for a reconstruction for limb salvage, and reasonably good results can be anticipated.