SUPERFICIAL FEMORAL VEIN - A USEFUL AUTOGENOUS HARVEST SITE

Purpose: The purpose of this study was to present the use of superfici al femoral vein (SFV) as an arterial bypass graft when ipsilateral sap henous vein is inadequate. Methods: Data collected prospectively were reviewed on 24 patients (25 limbs) who had an arterial bypass with SFV performed by the authors between January 1, 1988, and December 31, 19 91. Many anatomic sites are represented. The indication for operation was gangrene in six patients, severe rest pain or ulceration in 11, mi ld to moderate rest pain in six, and graft infection in two. There had been 42 previous reconstructions in these 25 Results: There has been surprisingly little long-term disability from removal of the SFV. Imme diately after surgery four limbs developed acute venous congestion tha t resolved quickly. Twenty percent of the patients with patent grafts have continued to wear a pressure gradient stocking for swelling 1 yea r after surgery, one patient requires additional pressure to control i nduration. All grafts were patent at 30 days. During a mean follow-up of 2 years, three grafts have required revision, and three have occlud ed. Stenosis did not develop at valve sites or in the body of the SFV portion of any of these grafts. There were two deaths from heart-relat ed causes in the first 30 days after operation. Life-table analysis fo r the whole group shows a primary patency rate of 66% (SE 10.3%) and a n assisted patency rate of 80% (SE 8.7%) at 2 years. Conclusions: SFV harvest is well tolerated, even in the absence of ipsilateral saphenou s vein. The magnitude of the operation is greater than saphenous vein harvest but yields a thick-wailed vein of excellent diameter with many applications as an autogenous conduit, particularly where a large-dia meter graft is indicated.