Long term behavior of reversed saphenous vein grafts for advanced femoropopliteal disease.
Fifty consecutive long saphenous vein graft operations for limb salvage performed between 1958 and 1965 were observed by periodic arteriography. Of 50 grafts, 11 failed within two years, and at the time of the final review, two patients had defaulted. Extended observations of the remaining 37 grafts up to 15 years showed three main complications. First, graft degeneration affected seven grafts with earliest evidence of elongation, tortuosity, irregular dilation or aneurysmal formation at four years. It did not affect any graft after eight years. One graft required replacement because of degeneration. Second, proximal dilation was seen in six grafts, but it did not compromise patency or function and had a maximal incidence at four to six years. Third, the site of the distal anastomosis was narrowed in eight patients, but the narrowing was severe in four. This complication occurred at six to eight years and affected 25 per cent of the surviving patients. The narrowing was caused by thrombus formation within the area of anastomosis and was amenable to further arterial reconstruction.
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D014182:Transplantation, Autologous; D014656:Vascular Surgical Procedures / Q000379:methods