Use of varicose saphenous veins for infrainguinal bypass is often contraind
icated because of the risk of immediate rupture or long-term aneurysm. In t
his report we describe four cases in which prosthetic reinforcement allowed
successful femoropopliteal bypass grafting using highly varicose saphenous
veins while preserving normal endothelium. No thrombosis or any other comp
lication was observed after a mean follow-up of 41 months.