The Superficial Femoral-Popliteal Vein Graft: A Reliable Conduit for Large-Caliber Arterial and Venous Reconstructions

Abstract

Vascular surgeons are increasingly called upon to perform arterial reconstructions in patients who have unusable or absent saphenous veins forcing consideration of alternative conduits. Although prosthetic grafts have excellent performance when used as bypasses involving the aorta and its branches, there are clearly circumstances in which autogenous conduits are preferable. The superficial femoral popliteal vein (SFPV) has proven to be an outstanding alternative in these situations. Although the SFPV was originally used at our institution for the treatment of aortic graft infections, the success of reconstructions for this indication has led us to utilize the SFPV conduit in many other situations. The SFPV has proven to be superior to prosthetic grafts for infrainguinal limb salvage procedures and for hemodialysis access in certain situations. In addition, the SFPV appears to be the conduit of choice for use in infected fields of all types and for large caliber venous reconstructions. The purpose of this article is to review the use of the SFPV conduit in creation of the neoaortoiliac system (NAIS), update our results, and survey alternative uses for this versatile conduit. We also address the technical details of its harvest and implantation technique.