Deep veins of the leg as femoropopliteal bypass grafts

Deep leg veins were used as femoropopliteal grafts in 13 patients treated with limb loss (average age, 77.5 years). Runoff was poor in ten patients, and three required transmetatarsal amputations. Early limb salvage was achieved in all cases. Nine (69%) of 13 grafts were either patent when last examined (four patients, 21.5 months average follow-up) or remained patent until the patient's death (five patients, 29 months average follow-up). Two of the late failures (six and seven months), occurred in the three patients who had secondary or complicated reconstructions. In the ten patients whose deep veins were used as primary grafts, eight have remained patent (average follow-up, 24.8 months) and two have become occluded (seven and 21 months). There was no operative mortality and minimal morbidity, suggesting that in patients threatened with limb loss and unavailable saphenous veins, the superficial femoral and popliteal veins may be the graft materials of choice.