The in situ saphenous vein bypass has been introduced in our departmen
t since 1989. A total of 26 bypasses in 22 patients have been followed
prospectively. Indications for revascularisation have been severe art
erial insufficiency in 73% of the cases (stage III or IV). With the ex
ception of one postoperative death (myocardial infarction), all the pa
tients have recovered uneventfully, with a regression to stage 1. No a
mputation has been necessary. Morbidity has been 30%, with mainly mino
r local complications. The primary patency rate is 83% at one year and
78% after 2 and 3 years, whereas the secondary patency rate is 91% at
one year, and remains constant thereafter up to 3 years. Considering
our results and those from the literature, we believe that the in situ
technique is very valuable, especially for below-knee vascular recons
truction. Technical difficulties of the method are analysed.