Sequential femorotibial bypass: clinical results

Sequential bypass grafting is a technique designed to improve blood flow in selected patients who require femorotibial bypass grafting. In an attempt to augment runoff we have constructed a side-to-side anastomosis between the saphenous vein and an open popliteal segment in addition to the distal anastomosis between the vein graft and the tibial artery. The sequential bypass technique was used in 15 patients and limb salvage was the operative indication in all but 1 of these. All grafts remained patent in the early postoperative period. During a follow-up period of 2 to 43 months, the patency rate was 86% while the cumulative patency among those followed up for more than 1 year was 78%.