Nonreversed translocated saphenous vein bypass for arterial trauma

Nonreversed translocated saphenous vein (NTSV) bypasses were performed for 17 acute arterial injuries. The technique involved controlling hemorrhage, inserting indwelling shunts, perfusing the harvested saphenous vein with papaverine solution, placing the vein in a nonreversed orientation over the shunt, performing valvulotomy under arterial pressure with a modified Mills' valvulotome and completing the distal anastomosis just before removing the shunt. Followup ranged from 2 to 36 months. There were no graft occlusions. The advantages of using NTSV graft for reconstruction of arterial injuries include autogenous reconstruction, reduced size discrepancy between graft and artery at both the proximal and distal anastomosis, improved hemodynamics when spasm compromises distal runoff, and increased vein utilization. NTSV provides increased versatility with both large and small vessel trauma and may improve patency rates.