Long-Term Comparison of in Situ and Nonreversed Saphenous vein Grafts for Infrapopliteal Reconstruction

Abstract

The nonreversed saphenous vein bypass graft has become a reasonable alternative to the standard in situ technique for infrainguinal arterial reconstruction. The objective of this study was to compare the long-term results obtained with these techniques in patients with severe limb ischemia. Fifty-five in situ and 57 nonreversed saphenous vein bypass grafts to the infrapopliteal arteries were compared for secondary graft function, preser vation of the foot, and patient survival. The crude relative risk of secondary failure for nonreversed grafts was 1.03 (95% confidence interval [95%CI] 0.62-1.69). Stratified analysis showed a stable relative risk of 1.04 (95%CI 0.58-1.86) in the stratum of 33 nonreversed and 47 in situ grafts done with both a good vein and a high origin. Conflicting results were found in the other strata as a result of small stratum size. The relative risks for major amputation and death were 0.60 (95%CI 0.35-1.05) and 0.44 (95%CI 0.25-0.79), respectively.

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