LONG-TERM COMPARISON OF IN-SITU AND NONREVERSED SAPHENOUS-VEIN GRAFTSFOR INFRAPOPLITEAL RECONSTRUCTION

The nonreversed saphenous vein bypass graft has become a reasonable al ternative to the standard in situ technique for infrainguinal arterial reconstruction. The objective of this study was to compare the long-t erm results obtained with these techniques in patients with severe lim b ischemia. Fifty-five in situ and 57 nonreversed saphenous vein bypas s grafts to the infrapopliteal arteries were compared for secondary gr aft function, preservation of the foot, and patient survival. The crud e relative risk of secondary failure for nonreversed grafts was 1.03 ( 95% confidence interval [95%CI] 0.62-1.69). Stratified analysis showed a stable relative risk of 1.04 (95%CI 0.58-1.86) in the stratum of 33 nonreversed and 47 in situ grafts done with both a good vein and a hi gh origin. Conflicting results were found in the other strata as a res ult of small stratum size. The relative risks for major amputation and death were 0.60 (95%CI 0.35-1.05) and 0.44 (95%CI 0.25-0.79), respect ively.