TECHNICAL ASPECTS AND RESULTS OF THE OPEN IN-SITU SAPHENOUS-VEIN BYPASS TECHNIQUE

We reviewed 284 consecutive in situ saphenous vein bypass procedures p erformed for limb salvage over a 66 month period. All procedures were performed using an open technique with a modified Mills retrograde val vulotome using an incision exposing the whole vein. Ninety-eight perce nt were to the infrageniculate level (18% below knee popliteal and 80% crural). All patients had preoperative B-mode saphenous vein mapping. Intraoperative arteriographic and continuous wave Doppler evaluations were done on each bypass. Routine color duplex imaging was performed on all bypassess postoperatively. Primary and secondary patency rates for all in situ bypassess at 48 months were 68% and 86%. The periopera tive mortality was 2.5%. All deaths were secondary to cardiovascular c auses. We believe that the open technique with a retrograde valvulotom e provide satisfactory long-term patency, high operability and an exce llent vein utilization rate.