Technique for Reversed Vein Femoropopliteal Graft

IN FEMOROPOPLITEAL vein bypass, we have found the use of a catheter traversing the graft and then the popliteal artery to be helpful for three reasons. They are as follows: (1) it delineates the lumen of the vessel; (2) it delineates the edges of the vessel wall, permitting accurate apposition to the graft and preventing narrowing at the distal anastomosis; and (3) it permits atraumatic constriction of the wall of the vessel around the catheter, which is then clamped proximally as it extends above the graft to prevent back-bleeding.

The artery is first explored to determine its suitability for grafting. The saphenous vein is then dissected out, removed, and immersed in heparin solution (50 mg/100 cc saline). The common femoral and femoropoliteal arteries are next freed of their surrounding tissues. Efforts are made to preserve the collaterals which are important in the maintenance of flow distal to the block.

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