[Reconstruction of the femoro-popliteal and peripheral portion in saphenous insufficiency]

Implantation of a venous bypass is the best method of infraarticular and crural reconstructions. In 30%, however, a suitable saphenous vein is not available. If on account of severe ischemia revascularization is necessary, an alternative method must be selected. From a total number of 326 peripheral reconstructions with a distal anastomosis into the distal popliteal artery or crural artery the authors had to use instead of a long venous bypass a subsidiary reconstruction in 145 patients (44.6%). The authors implanted composite venous bypasses in 36 patients (24%), in 93 patients (64%) they combined a venous bypass with desobliteration of the superficial femoral artery and in 16 patients (11%) with an artificial prosthesis. For the end-to-end anastomosis of the prosthesis and vein the authors suggested a plastic operation by means of a venous patch which makes a short anastomosis possible with a smooth transit from a wide prosthesis into a narrow vein. The authors assume that in future ever more frequently the combination prosthesis and vein in the shape of a jump bypass will be preferred to other reconstructive methods, as it is relatively simple and rapid. Their hitherto assembled experience with this methods is favourable.