VS12P USE OF THE SUPERFICIAL FEMORAL POPLITEAL VEIN AS A CONDUIT IN SELECTED VASCULAR SCENARIOS

Abstract

In 1986 Schulman et al first reported the use of the superficial femoral popliteal vein (SFPV) as a conduit for femoral‐popliteal arterial bypass. Since then it has been well reported as an alternative conduit in various scenarios, predominantly in the reconstruction of a neoaortoiliac system for infected prosthetic aortic grafts.It is a large calibre vessel, 8–12 mm in diameter, with good handling properties, a high graft patency rate, and a thick wall rendering it resistant to infection. Aneurysmal change occurs rarely after long‐term follow‐up. Anatomic studies show that on average lengths of 40–50 cm in men and 30–40 cm in women can be harvested on each side with minimal symptomatic venous consequences. Less than one third of patients after SFPV harvest develop oedema despite significant venous outflow obstruction on plethysmography. These characteristics make it an excellent conduit for both venous and arterial bypass in selected vascular cases.We present a series of 3 patients in whom the SFPV was used as a conduit. The first was an iliofemoral bypass for an isolated traumatic iliac artery dissection in a 35 year old man. The second was a complex 4th redo for a failed femoral‐popliteal bypass operation. The third was a portal vein reconstruction during a pancreaticoduodenectomy for a pancreatic tumour encasing the portal and superior mesenteric veins. In all 3 cases the grafts have remained patent during follow‐up, with only one patient developing symptomatic oedema.This case series illustrates the wide spectrum of applications for this safe and effective conduit. Used until now mostly as a rescue conduit after the failure of synthetic grafts, should SFPV be considered as the first choice for younger patients?