WRAPPED AUTOLOGOUS GREATER SAPHENOUS-VEIN BYPASS FOR SEVERE LIMB ISCHEMIA IN PATIENTS WITH VARICOSE-VEINS - PRELIMINARY-REPORT

The greater saphenous veins in patients with varicose veins has been o verlooked as a conduit for arterial bypass. Greater saphenous veins is often normal and when only parts of the greater saphenous veins are o f normal size, a veno-venous or a graft composite bypass may be perfor med. The goal of this preliminary study was to asses if wrapped autolo gous greater saphenous veins could be suitable conduits for arterial b ypass in patients presenting with critical ischemia. In three patients the greater saphenous veins had one to four dilatations which were wr apped with short segments of Polytetrafluoroethylene graft. In three o ther patients, the dilated area being longer, the greater saphenous ve ins were totally wrapped in a hand-made mesh of Dacron. No complicatio ns were due to the wrapping procedure and the unwrapped segments did n ot dilate during a mean three year follow-up. We conclude that wrapped autologous greater saphenous veins may help save Limbs of patients wi th critical ischemia. As an underestimated proportion of patients pres enting with varicose tributaries have normal or quite normal greater s aphenous veins, the caliber of the greater saphenous veins should be c arefully measured before treating the varicose veins. Ah greater saphe nous veins suitable for an arterial bypass should be preserved remembe ring that one or several dilatations may be wrapped if the greater sap henous veins is used as an arterial substitute. Patients should be inf ormed of the reasons for this choice.