Abstract
BackgroundThe use of autologous superficial femoral veins (SFV) as an arterial or venous substitute represents a valuable technique in modern vascular surgery with versatile indications. The SFV autografts exhibit excellent control of infection and durable long-term results in terms of graft patency in prosthetic or arterial infections. In cases of elective use of the SFV, duplex ultrasound evaluation of the deep leg vein system should be implemented to confirm the patency of the profunda femoris vein.Material and methodsThe SFV can be harvested distal to the adductor hiatus with a proximal portion of the popliteal vein but should not exceed the level of the knee joint. Formation of a stump of the proximal SFV must be avoided. Simultaneous harvesting of the ipsilateral greater saphenous vein should be avoided to reduce the risk of significant chronic edema.ResultsEarly postoperative swelling of the donor leg can be expected but resolves spontaneously in most cases. Chronic mild edema of the leg with a possible indication for compression therapy may occur in up to 20 % of cases but severe complications are very rare if the anatomical borders for vein harvesting are respected. Temporary therapeutic anticoagulation after vein harvest is subject to individual decision making.ConclusionDuplex ultrasound is a reliable tool to assess the residual deep and superficial venous system in the long term. Excellent graft function and the tolerable adverse effects of vein harvest on the donor leg justify the use of the SFV in arterial and venous vascular surgery if indicated.
Highlights
It is thanks to Martin Schulman that the significance of deep leg veins, the superficial femoral vein (SFV), as an autologous vascular graft in arterial and venous vascular surgery was recognized and that it is finding increasingly broader applications
The use of autologous superficial femoral veins (SFV) as an arterial or venous substitute represents a valuable technique in modern vascular surgery with versatile indications
In cases of elective use of the SFV, duplex ultrasound evaluation of the deep leg vein system should be implemented to confirm the patency of the profunda femoris vein
Summary
It is thanks to Martin Schulman that the significance of deep leg veins, the superficial femoral vein (SFV), as an autologous vascular graft in arterial and venous vascular surgery was recognized and that it is finding increasingly broader applications. AV arteriovenous, EVAR endovascular aortic repair, PTFE polytetrafluoroethylene afemorofemoral bypasses were placed for aortoiliac disease tion to the excellent data on fully autologous reconstruction in septic vascular surgery involving the repair of infected conventional vascular grafts or mycotic aneurysms [6, 7, 9,10,11,12,13,14,15,16], results on the successful use of this approach in infected stents or stent grafts are available [17,18,19] This applies to the thoracic or thoracoabdominal aorta in individual cases [20, 21]; the SFV has proved its worth as a permanent conduit for other indications. There are indications for its use in the reconstruction of large veins [32], such as the superior [33,34,35,36,37,38] and inferior [39,40,41] vena cava, as well as in
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