Infrageniculate vein bypass graft for critical limb ischaemia: one surgeon's experience

The results of 63 patients under the care of one surgeon who underwent a bypass, using vein, for critical limb ischaemia are presented. Thirty-two operations were to the crural vessels and the results are compared with those for 31 infrageniculate femoropopliteal bypasses. All patients were entered into a graft surveillance programme. There were no graft failures after 1 year in the femoropopliteal group with primary, primary assisted and secondary patency rates of 86, 90 and 93% respectively at 3 years. In the femorocrural group the rates were 55, 60 and 64% respectively. The difference in secondary patency was considered statistically significant (P < 0.01). Mortality rate of the femoropopliteal group was 31% at 3 years compared with 53% for the femorocrural group (n.s.). Five patients underwent major amputation, all of whom were in the femorocrural group. Failures, interventions and the effect of graft surveillance are discussed and the high mortality rate is highlighted.