Femoro-Popliteal Vein Bypass for Isolated Obstructions of the Superficial Femoral Artery:Significance of Level of Proximal Anastomosis

Abstract

Incapacitating claudication or impending gangrene was present in 27 patients with isolated obstruction of the superficial femoral artery. The deep femoral artery was patent and the aorto-iliac blood flow was deemed adequate in all cases. It is concluded that femoro-popliteal vein bypass is the method of choice for this condition. Shunt reconstruction was carried out on 29 extremities, which to date have been followed from 3 months to 3 years after surgery. Seventeen of 19 claudicants were significantly improved, while 5 of 10 procedures for impending gangrene were successful. The 7 instances of shunt failure all occurred during the first year after surgery, and 5 of these within 3 months. In 12 extremities, the bypass vein was anastomosed to the common femoral and in 17 extremities to the superficial femoral artery. The level of anastomosis did not influence the shunt patency rate. In performing the lowest anastomosis, however, temporary occlusion of the patent deep femoral artery can be avoided.