Prosthetic above-knee femoral-popliteal bypass: indications and choice of graft.

In this article, the use of prosthetic grafts for above-the-knee femoral-popliteal arterial bypass reconstruction is discussed. The issue as to whether prostheses should be used preferentially, selectively, or not at all, remains both topical and controversial in vascular surgical circles. The debate has been heightened by a recently presented, and soon to be published, randomized prospective trial comparing two different prostheses, knitted polyester and polytetrafluoroethylene. The results showed equivalent patency rates and reasonably satisfactory overall results. The general considerations (pro and con) as whether to proceed with prosthetic repair and, if so, which graft to select in such patients, is elaborated on this issue, and a recommendation appropriate to the perspective of 1997 is presented.