INFRAINGUINAL RECONSTRUCTION WITH ARM VEIN, LESSER SAPHENOUS-VEIN, AND REMNANTS OF GREATER SAPHENOUS-VEIN - A REPORT OF 257 CASES

Purpose: The purpose of this study was to evaluate the results of infr ainguinal reconstructions with arm vein, lesser saphenous vein, and re mnants of greater saphenous vein (ectopic vein grafts). Methods: The r ecords of 222 patients who underwent 257 bypasses were retrospectively reviewed. Most of the grafts were placed for rest pain or tissue loss (88%) and were secondary reconstructions (70%) to the infrapopliteal level (90%). Single-length vein grafts were constructed in 66% of case s, whereas 34% were composite vein grafts. Results: Secondary graft pa tency was 70%, 52%, and 43% at 1, 3, and 5 years. Single-length grafts had significantly better patency rates at all intervals: 78% versus 5 6% 0.001), 60% versus 39% at 3 years (p = 0.004), and 52% versus 29% a t at 1 year (p = 0.002). The limb salvage rate was 69% at 5 years. 5 y ears (p Conclusions: Ectopic vein grafts with primarily arm vein are a n acceptable alternative for infrainguinal reconstruction in the absen ce of suitable ipsilateral greater saphenous vein.