Abstract
Femoral-popliteal bypass graft should be considered for critical limb ischemia manifested by tissue loss (gangrene), ischemic ulcer, rest pain, and uncommonly for persistent lifestyle-limiting claudication. Autogenous greater saphenous vein is preferred as a conduit due to its higher patency and limb salvage rates. Patency rate for expanded PTFE graft below the knee is significantly inferior to autogenous vein. Preoperative vein mapping is useful to assess the quality of the greater saphenous vein. For optimal patency, the vein should be at least 3 mm in diameter. Proximal anastomosis is performed to the common femoral artery. The site of distal anastomosis is selected from the results of catheter-based arteriography and quality of the artery at the time of exposure.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Henry TD, Schwartz RS, Hirsch AT. “POBA plus”: will the balloon regain its luster? Circulation. 2008;118(13):1309–11.
Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007;45(Suppl S):S5–S67.
Regensteiner JG, Hiatt WR, Coll JR, et al. The impact of peripheral arterial disease on healthrelated quality of life in the peripheral arterial disease awareness, risk, and treatment: new resources for survival (PARTNERS) program. Vasc Med. 2008;13(1):15–24.
Hirsch AT, Hartman L, Town RJ, et al. National health care costs of peripheral arterial disease in the Medicare population. Vasc Med. 2008;13(3):209–15.
Femoral Endarterectomy and Femoral Popliteal Bypass Christopher J. Smolock Y Keith Glover Netter’s Surgical Anatomy and Approaches second eddition, Elsevier, Inc. 2021;479−486.
Erwin PA, Shishehbor MH. Contemporary management of femoral popliteal revascularization.
Klinkert P, Schepers A, Burger DHC, et al. Vein versus polytetrafluoroethylene in above-knee femoropopliteal bypass grafting: five-year results of a randomized controlled trial. J Vasc Surg. 2003;37:149–55.
Pereira CE, Albers M, Romiti M, et al. Meta-analysis of femoropopliteal bypass grafts for lower extremity arterial insufficiency. J Vasc Surg. 2006;44:510–7.
Conte MS, Pomposelli FB, Clair DG, Geraghty PJ, JF MK, Mills JL, Moneta GL, Murad MH, Powell RJ, Reed AB, Schanzer A, Sidawy AN, Society for Vascular Surgery; Society for Vascular Surgery Lower Extremity Guidelines Writing Group. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg. 2015;61(3 Suppl):2S–41S.
Ambler GK, Twine CP. Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev. 2018;2:CD001487.
Johnson WC, Lee KK. A comparative evaluation of polytetrafluoroethylene, umbilical vein, and saphenous vein bypass grafts for femoral-popliteal aboveknee revascularization: a prospective randomized Department of Veterans Affairs cooperative study. J Vasc Surg. 2000;32:268–77.
Veith FJ, Gupta SK, Ascer E, et al. Six-year prospective multicenter randomized comparison of autologous saphenous vein and expanded polytetrafluoroethylene grafts in infrainguinal arterial reconstructions. J Vasc Surg. 1986;3:104–14.
Harris PL, Veith FJ, Shanik GD, et al. Prospective randomized comparison of in situ and reversed infrapopliteal vein grafts. Br J Surg. 1993;80:173–6.
Watelet J, Soury P, Menard JF, et al. Femoropopliteal bypass: in situ or reversed vein grafts? Ten-year results of a randomized prospective study. Ann Vasc Surg. 1999;18:149–57.
Mills JL Sr. P values may lack power: the choice of conduit for above-knee femoropopliteal bypass graft. J Vasc Surg. 2000;32:402–5.
Stonebridge PA, Prescott RJ, Ruckley CV. Randomized trial comparing infrainguinal polytetrafluoroethylene bypass grafting with and without vein interposition cuff at the distal anastomosis. The Joint Vascular Research Group. J Vasc Surg. 1997;26:543–50.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Natour, A.K., Kabbani, L. (2023). Femoral-Popliteal Bypass Graft. In: Hans, S.S., Weaver, M.R., Nypaver, T.J. (eds) Primary and Repeat Arterial Reconstructions. Springer, Cham. https://doi.org/10.1007/978-3-031-13897-3_32
Download citation
DOI: https://doi.org/10.1007/978-3-031-13897-3_32
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-13896-6
Online ISBN: 978-3-031-13897-3
eBook Packages: MedicineMedicine (R0)