Deep veins of the leg as femoropopliteal bypass grafts
M. L. Schulman and M. R. Badhey
Deep leg veins were used as femoropopliteal grafts in 13 patients treated
with limb loss (average age, 77.5 years). Runoff was poor in ten patients,
and three required transmetatarsal amputations. Early limb salvage was
achieved in all cases. Nine (69%) of 13 grafts were either patent when last
examined (four patients, 21.5 months average follow-up) or remained patent
until the patient's death (five patients, 29 months average follow-up). Two
of the late failures (six and seven months), occurred in the three patients
who had secondary or complicated reconstructions. In the ten patients whose
deep veins were used as primary grafts, eight have remained patent (average
follow-up, 24.8 months) and two have become occluded (seven and 21 months).
There was no operative mortality and minimal morbidity, suggesting that in
patients threatened with limb loss and unavailable saphenous veins, the
superficial femoral and popliteal veins may be the graft materials of
choice.