The use of arm vein as an alternative conduit for lower-extremity bypass

A 4-year retrospective review of all cases utilizing arm vein for lower-extremity bypass was undertaken. Thirty-six cases were reviewed. The patients had portions of the basilic or cephalic arm veins, or both, harvested and used as a bypass for limb salvage. Composite grafts using a portion of arm vein were excluded. Information on demographics, risk factors, vascular surgical history, presenting signs and symptoms, surgical complications, patient comfort (arm vs. leg pain), and patency rates was studied. We found that all patients were initially seen with claudication or rest pain, that 22% had gangrenous changes, that there was a male dominance (75%), and that all had previous coronary artery bypass grafts or lower-extremity bypass. Limb salvage rate was 85% at 4 years. Primary patency rate was 71% at 4 years. We conclude that arm vein is a useful and durable conduit for bypass. Patient acceptance and comfort is high.