Preferential use of nonreversed vein grafts in above-knee femoropopliteal bypasses for critical ischemia: midterm outcome.

We evaluated nonreversed vein grafts in above-knee bypasses for chronic critical limb ischemia in a retrospective study with intention-to-treat analysis in patients who underwent above-knee bypass grafting. During a 4-year period, 51 patients (men, 32; women, 19; mean age = 66 years) with 53 critically ischemic lower extremities underwent above-knee femoropopliteal bypass grafting. The follow-up evaluation consisted of clinical examination, assessment of the ankle-brachial systolic blood pressure index, and, whenever necessary, duplex scanning.

Importance of the arteriographic anatomy of the descending genicular artery and sural arteries in patients with atherosclerotic occlusion of the popliteal artery.

Bypasses to the descending genicular artery (DGA) or the medial sural artery (MSA) have been performed with acceptable rates of midterm success. The arteriographic appearance of the DGA, the MSA, and the lateral sural artery (LSA) was described and the applicability of bypass to these vessels was investigated. The arteriograms of 45 patients who had occlusion of the below-knee popliteal artery were analyzed to determine the presence, dominance, and extension of collaterals for each perigeniculate branch, which were used to assess the applicability of a perigeniculate bypass.