Saphenous vein bypass grafting. Changes in native circulation and collaterals

One hundred patients were evaluated 12 to 43 months after saphenous vein bypass surgery. The rate of progression of obstructive disease in the native vessels and changes in collateral circulation were analyzed in detail. Fifty-five per cent of preoperatively patent vessels showed progression proximal to the site of graft insertion, 40% proximal to patent grafts; there was distal progression in only 7% of grafted vessels. The progression rate for nongrafted vessels was 14%. Patent grafts were associated with a high rate of disappearance of collaterals to the grafted vessels, while occluded grafts were associated with preservation of collaterals or appearance of new collaterals. Progression of obstructive disease in the native circulation and changes in collaterals did not prevent symptomatic improvement (93% of patients were symptomatically improved).