Femoropopliteal Vein Bypass: The Problem Proximal Anastomosis

Arch Surg. 1978;113(6):779. doi:10.1001/archsurg.1978.01370180121031.
Text Size: A A A
Published online

Excessive proliferation and separation of the intima in the common femoral artery mitigates against the successful performance of the proximal anastomosis in the operation of femoropopliteal vein bypass.1 The rigidity of the atherosclerotic material renders the artery inflexible and prevents adequate dilation of the arteriotomy after completion of the vein anastomosis. Full thickness sutures passing through the arterial wall drag the cut margin of the vein level with the intima. With the vein lying parallel to the artery these two factors combine to produce a kink at the heel of the anastomosis that might have hemodynamic significance (Fig 1, A and B).

A number of technical maneuvers have been suggested to overcome this problem. An elipse of artery may be excised and the anastomosis constructed with sutures passing only through the adventitio-medial plane. This obviates kinking and creates an hemodynamically acceptible anastomosis; but because the intima is left unsecured,


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.