The bypass principle in the treatment of segmental vascular occlusions was apparently initiated by Kunlin and associates1 in 1951, who employed an autologous vein to bridge an arterial occlusion. However, only in the past year or two, with the use of homologous arterial grafts, has the principle enjoyed widespread acceptance and application. The arterial graft seems to have definite advantages over the venous graft. Several American surgeons * have already reported quotable success in large series of patients with arteriosclerotic occlusive disease of the lower extremities treated by bypass arterial grafts.
Reasons for the popularity of this method are obvious. The risks inherent in endarterectomy or in arterial resection with graft replacement appear to be virtually absent in the bypass operation. Existing circulation is not disturbed and is therefore not endangered. The incidence of failure appears to be less than that of other procedures. Unless an occlusion progresses rapidly in