@article{fc7528914e3d4de48f23fc08a732b30c,
title = "Autogenous reversed vein bypass for lower extremity ischemia in patients with absent or inadequate greater saphenous vein",
abstract = "This report has presented the results of 329 reversed vein bypasses performed for lower extremity ischemia over a 6 3 4 year period. One hundred eighty-nine bypasses were formed from intact ipsilateral greater saphenous veins of adequate size and length. One hundred forty bypasses were formed in patients in whom the ipsilateral greater saphenous vein was absent or of inadequate size or length to complete the bypass. The grafts in these patients were accomplished using a variety of techniques including distal graft origin, use of arm veins and lesser saphenous veins, and use of vein splicing. The patency rates of these grafts were equivalent to those achieved using adequate intact ipsilateral greater saphenous vein. In view of these results, we conclude that the absence of a greater saphenous vein does not preclude successful autogenous lower extremity vein bypass and that prosthetic bypass is rarely justified.",
author = "Taylor, {Lloyd M.} and Edwards, {James M.} and Bolek Brant and Phinney, {Edward S.} and Porter, {John M.}",
note = "Funding Information: Abundant evidence mdlcates that a normal lpalat-eral, autogenous greater saphenous vem 1s the graft material of choice for lower extremity arterial by-pass for lschemla [I] However, as many as 40 percent of patients requiring lower extremity bypass do not possess an adequate greater saphenous vem for a variety of reasons, mcludmg previous stripping or use for arterial bypass or mtrmslc vein abnormah-ties, mcludmg small size, sclerosis, or varlcosltles In contrast to the consensus regarding the supen-orlty of greater saphenous vein when avculable, there IS no consensus regarding the bypass procedure of choice for lower extremity lschemla m its absence. Options include the use of prosthetic grafts or the use of a variety of techniques to permit autogenous reconstruction Among these are alternate sources of autogenous vein, including opposite leg veins, arm veins, lesser saphenous veins, or sphcmg of vein segments from multiple alternate sources, and distal graft orlgm from the superficml femoral, deep femoral, or pophteal arteries to permit use of a shorter segment of vein Although it 1s clear that all of these alternate techniques for autogenous reconstruction are techmcally possible, opinions differ concernmg their superlorlty over the use of prosthetic grafts, which clearly have the advantage of convenience In our practice, we use autogenous vein techniques for lower extremity bypass Since 1980, we have performed 329 autogenous vein bypasses for lower extremity lschemla m 264 patients A comparison of the results of the procedures performed us-Fromth eD ivlsloonf vascularS urgeryC regonH ealthS ciencesUnlverslty, PortlandO, regonS upportedin part by Grant RR00334 from ths General ClinicaRl esearchC enterB ranchD, hr~sioonf Research Resources, National Institutes of Health, Bethesda. Maryland Requests for reprints should be adrewed to Lloyd M Taylor, Jr, MD, Division of Vascular Surgery, University of Dregon Heslth Sciences Center 3181 SW Sam Jackson Park Road, Portland, Oregon 97201 Presented at the 73rd Annual Meeting of the Norlh Paclflc Surgical Assoclatlon Tacoma, Washington, November 14 and 15, 1986",
year = "1987",
month = may,
doi = "10.1016/0002-9610(87)90803-8",
language = "English (US)",
volume = "153",
pages = "505--510",
journal = "The American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "5",
}