Percutaneous Femoropopliteal Graft Placement

Femoropopliteal bypass surgery is now recommended for the treatment of long-segment or diffuse superficial femoral artery disease. The authors describe a technique for percutaneous placement of a prosthetic femoropopliteal graft. The technique has been accomplished with conventional polytetrafluoroethylene graft material and a variety of implantation techniques in eight patients. Technical success was achieved in all patients who underwent graft placement. Grafts up to 28 cm in length were placed, and graft patency was demonstrated up to 10 months after implantation. Six of the eight patients were asymptomatic during the follow-up period; one patient who had symptoms during this time underwent thrombolysis and redilation of the distal stent, and the symptoms resolved. In the other patient with symptoms, the procedure failed clinically because of poor runoff. This study demonstrates the feasibility of percutaneous graft placement in the femoral artery, but durability must be established in relation to traditional bypass surgery before it can be recommended on a wider scale.