The Advantages of the Great Saphenous Vein as a Femoropopliteal Graft:A Report on Its Clinical Use

Abstract

The autologous saphenous vein is preferred as a bypass graft below the inguinal ligament. The need for alternative graft materials or reconstructive techniques is confined to patients with unavailable or unsuitable saphenous veins. Formerly the great saphenous vein was used as a femoropopliteal graft without regard to fixed limitations in the diameter and the quality of the vein. During this period, vascular reconstruction was required in 148 limbs due to symptomatic atherosclerotic occlusion of the superficial femoral artery. In 144 of these cases, the ipsilateral (138) or the contralateral (6) great saphenous vein was used for a femoropopliteal bypass reconstruction. The vein could not be utilized in 4 of 148 cases (2.7%). Graft patency rate was not subject to the size and quality of the vein. Cumulative patency rates in the 144 grafts were most satisfactory (97.9, 92.0 and 81.9% at 1 mo., 1 yr and 5 yr, respectively). The great saphenous vein can be used more liberally as a graft for femoropopliteal occlusion. In approximately only 3% of patients requiring operation, alternative reconstructive techniques, such as non-vein bypass grafts and thromboendarterectomy are needed.