The Use of Arm Veins in Femoral-Popliteal Bypass Grafts

Abstract

To determine the best alternative to saphenous vein for femoral-popliteal bypass grafts in peripheral vascular disease patients, arm vein grafts were used. Arm veins were used when saphenous vein was unavailable in 18 femoral-popliteal or femoral-tibial bypass grafts. Of the patients, 83%, were diabetic. Of the patients, 94% were operated on for limb salvage, and in 67% the arteriograms showed fair to poor run-off. Despite this, the 1 yr patency rate was 82%, which is significantly better than the 69% 1 yr patency rate obtained previously using cloth grafts. Autogenous vein remains the material of choice in femoral popliteal bypass grafts. Expanded polytetrafluoroethylene grafts or umbilical vein grafts have not yet been shown to be superior. Special techniques that are required when using arm veins are emphasized.