Autogenous in situ saphenous vein bypass for femoral-popliteal occlusive disease : A follow-up appraisal

Abstract

Results have been presented which indicate that the long term (two years) success of in situ autogenous saphenous vein bypass grafting for obstructing disease of the superficial femoral artery exceeds 83 per cent. These results are comparable to or better than those reported for autogenous vein shunts created by removal and reversal of the saphenous vein. Evidence has been presented to show that arteriovenous fistulas are not a complication of the in situ operation if an arteriogram is obtained before completion of the operation. Likewise the status of the valves made incompetent during the in situ operation has been examined grossly and microscopically. When the correct smooth tipped internal stripper is used, the valve is merely reversed upon itself and not torn. The in situ operation is recommended for long obstructive disease of the superficial femoral artery because of its simplicity of performance, preservation of vein viability, long term patency results, absence of foreign material, and lastly because it can be used safely in patients with claudication alone.