Document Detail

The case for an in situ lesser saphenous vein bypass.
MedLine Citation:
PMID:  11565046     Owner:  NLM     Status:  MEDLINE    
In situ lesser saphenous vein (LSV) graft has been advocated in cases where the greater saphenous vein is not available and the target arteries are confined to the lower leg. This is often the case of diabetic patients, whose occlusive disease pattern typically affects the tibioperoneal vessels, sparing the femoropopliteal segment. The in situ technique offers the potential advantages of decreasing surgical trauma to the vein and its vasa vasorum, better size-matching between vein and artery at the anastomoses, and improving hemodynamics. The authors reviewed the use of in situ LSV graft with attention to its indications and technical requirements. A 73- and a 76-year-old man presented with critical limb ischemia. Both had a history of diabetes, chronic renal failure, and previous use of the greater saphenous veins for coronary or peripheral bypasses. Both had good femoropopliteal inflow and tibioperoneal disease with single runoff through the distal peroneal and common plantar arteries, respectively. Venous mapping showed diminutive veins, with exception of an adequate ipsilateral lesser saphenous vein. The patients were placed in prone position for a posterior approach. The lesser saphenous veins were exposed through a longitudinal incision. Proximal anastomosis was based on the popliteal artery, exposed through the same incision. A successful in situ lesser saphenous vein bypass was performed by using the common plantar and the distal peroneal artery as target vessels. Both bypasses were patent at 24 and 18-months' follow-up, respectively. Selection criteria for in situ LSV bypass are patent femoral arteries; accessible target vessels in prone position through a medial, posterior, or lateral approach; and adequate LSV in diameter and length. In the authors' experience, in situ LSV bypass is a safe and simple option that offers successful distal revascularization.
G S Oderich; J M Panneton
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Vascular surgery     Volume:  35     ISSN:  0042-2835     ISO Abbreviation:  Vasc Surg     Publication Date:    2001 Sep-Oct
Date Detail:
Created Date:  2001-09-20     Completed Date:  2001-10-25     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0103277     Medline TA:  Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  403-8     Citation Subset:  IM    
Division of Vascular Surgery, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA.
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MeSH Terms
Arterial Occlusive Diseases / surgery
Coronary Artery Bypass*
Popliteal Artery / surgery
Saphenous Vein / surgery*
Vascular Surgical Procedures

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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