title: Lower extremity arterial revascularization using conditioned small-diameter great saphenous vein.
abstract: This study was conducted to determine whether it was feasible to increase the diameter of smaller great saphenous veins (GSVs) in preparation for possible bypass and whether such a conditioned conduit could be used with reasonable patency.
  
  
  
  Twenty-five patients (26 cases: 24 peripheral arterial occlusive disease, 2 popliteal aneurysms) with GSV diameters between 2 and 3 mm underwent in situ GSV valvulotomy and were observed for 3 months. After GSV dilation to >3 mm for below-knee revascularization and >3.5 mm for above-knee revascularization, arterial bypass surgery was performed with the valvulotomized GSV.
  
  
  
  Adequate GSV diameter was reached in 20 cases (77%). Arterial bypass surgery using valvulotomized GSV was performed an average 131 days (range, 64-373 days) after valvulotomy in 16 patients (61.5%). No deaths, amputations, or aneurysms occurred 2 years after surgery. At 1 and 2 years, primary patency was 81% ± 9.8% and 69% ± 11.8%, respectively, and secondary patency was 87% ± 8.3% and 75% ± 11%, respectively.
  
  
  
  Valvulotomy can be used to expand small-diameter GSV for lower extremity arterial bypass.
authors: Department of Vascular and Endovascular Surgery, Theresienkrankenhaus Mannheim, Mannheim, Germany. Electronic address: maherfattoum@yahoo.com.
authors: Maher
authors: M
authors: Fattoum
authors: Department of Vascular and Endovascular Surgery, Theresienkrankenhaus Mannheim, Mannheim, Germany.
authors: Stefan
authors: S
authors: Kennel
authors: Department of Vascular and Endovascular Surgery, Klinikum Darmstadt, Darmstadt, Germany.
authors: Peter
authors: P
authors: Knez
authors: Department of Vascular and Endovascular Surgery, Goethe-Universitätsklinikum Frankfurt, Frankfurt, Germany.
authors: Thomas
authors: T
authors: Schmitz-Rixen
authors: Department of Surgery, Glenfield Hospital, Leicester, United Kingdom.
authors: Hazem
authors: H
authors: Khout
authors: Department of Vascular and Endovascular Surgery, Theresienkrankenhaus Mannheim, Mannheim, Germany.
authors: Matthias H
authors: MH
authors: Tenholt
mesh_terms: D000783:Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005240:Feasibility Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010865:Pilot Projects; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D019233:Retreatment; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency