In situ saphenous vein bypass
J. E. Connolly and J. H. Kwaan
Our 20-year results with in situ saphenous vein grafting in the lower
extremity were reviewed and compared wih those where reversed saphenous
veins were employed. The ten-year patency rates for both types of grafts
terminating at the popliteal artery ranged from 41% to 43% and showed no
statistical difference. The reversed saphenous vein performed well in the
femoropopliteal position because the vein is usually of the same size at
the knee as in the groin and thus does not taper when reversed. We have
identified from our study specific indications for the in situ operation.
These indications are the presence of small or substantially tapering or
bifurcating great saphenous veins that otherwise would be unsatisfactory
for conventional reversed vein grafting. We believe that the in situ
saphenous vein operation should be considered before resorting to
prosthetic leg grafts that carry a lower long-term patency, particularly
when carried below the knee.
