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The in situ bypass above the knee
D Buchbinder1, W E Lloyd, D M Shah
1Department of Surgery, University of Health Sciences, Chicago Medical School, Illinois 60064.
Annals of Vascular Surgery
|July 1, 1989
Summary
The in situ saphenous vein bypass to the above-knee popliteal artery offers excellent long-term patency and is a technically straightforward procedure. This method demonstrates favorable outcomes for treating critical limb ischemia and claudication.
Area of Science:
- Vascular Surgery
- Surgical Innovation
- Peripheral Artery Disease
Background:
- The saphenous vein's anatomical position in the distal thigh facilitates in situ bypass grafting.
- Over 1400 in situ bypasses have been performed, with 43 specifically targeting the above-knee popliteal artery.
Purpose of the Study:
- To evaluate the efficacy and outcomes of in situ femoral-to-above-knee popliteal artery bypass grafting.
- To compare the patency rates of in situ bypasses with traditional methods.
Main Methods:
- Retrospective analysis of 43 in situ femoral-to-above-knee popliteal bypasses performed over 10 years.
- Patient demographics, indications for surgery, and graft patency were recorded and analyzed.
Main Results:
- Cumulative patency rates were 90% at two years and 77% at four years.
- The procedure is technically easy, with short operative times and low morbidity.
- Favorable comparison to reversed saphenous vein and polytetrafluoroethylene grafts.
Conclusions:
- In situ femoral-to-above-knee popliteal bypass is a safe and effective option for select patients.
- It offers comparable or superior patency rates to alternative bypass techniques.
- This technique should be considered for patients requiring femoral-to-above-knee bypass.