RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Jr., Robert M.
A1 Pawlik, Timothy M.
A1 Vaccaro, Patrick S.
A1 Bitans, Marita
A1 Baker, Anthony S.
SR Print(0)
ID 1187824524
T1 Saphenous Vein in Situ Arterial Bypass
T2 Zollinger’s Atlas of Surgical Operations, 11e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260440850
LK accesssurgery.mhmedical.com/content.aspx?aid=1187824524
RD 2024/10/15
AB Infrainguinal  arterial  bypass  procedures  may  be  indicated  in  patients  with  critical  limb  ischemia,  including  rest  pain,  tissue  loss  such  as  gangrene  of  the  toes  or  ulceration  of  the  foot  or  ankle,  or  with  progressive,  severe  claudication.  Compared  with  bypass  procedures  using  either  a  synthetic  graft  or  a  reversed  autogenous  saphenous  vein,  use  of  the  in  situ  saphenous  vein  technique  is  preferred  by  some  surgeons.  Currently,  there  are  no  significant  differences  in  patency  rates  between  the  in  situ  and  reversed  vein  grafts.  Hence  the  choice  is  largely  a  matter  of  surgeon  preference.  In  addition,  this  technique  may  be  preferred  when  the  distal  anastomosis  is  to  the  tibial  and  peroneal  arteries.  This  is  because  the  vein  size  tapers  in  the  anatomic  direction,  in  contrast  to  reversed  vein  grafts.  The  taper  results  in  a  better-matched  anastomosis  because  the  sizes  are  more  comparable  and  potentially  improved  hemodynamic  flow.  It  is  believed  that  all  these  factors  contribute  to  the  improved  results  over  prosthetic  material  for  a  biologically  living  bypass  graft  whose  natural  lining  is  not  thrombogenic.