Autogenous reconstruction is the conduit of choice for hemo dialysis access creation and lower extremity infrageniculate bypass. The benfits in terms of infection and patency are indisputable especially for the infrageniculate arterial bypass and the nontransposed upper extremity vein. The Brescia Cimino fistula is the gold standard for the nontransposed configuration. When autogenous vein is unavailable or inadequate in caliber, prosthetic leg bypass and bridge graft becomes the most suitable option.
Various graft diameters, configurations and technologies have been developed in an attempt to improve patency associated with prosthetic reconstruction.In leg bypass to the infrageniculate region, these options include autogenous vein cuffs, tailored hooded grafts, arteriovenous fistulas and chronic anticoagulation. The Gore Propaten graft is a heparin bonded polytetrafluoroethylene PTFE conduit that appears to have patency benefits in the short term. These results have been released from several short term studies See Results
Additional the Gore Viabahn is a heparin bonded endo prosthesis that is showing impressive results for the treatment for SFA occlusive disease SOURCE
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