J.Jpn. Surg. Soc.. 97(7): 551-556, 1996

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Feature topic

FEMOROPOPLITEAL BYPASS FOR PATIENTS WITH ARTERIOSCLEROSIS OBLITERANS

In this paper the current technical trend for femoro-popliteal bypasses (FP) was discussed. There is abroad consensus that vascular prostheses such as Dacron or ePTFE are reliable alternatives to autogenous vein grafts (AVG) for FP above the knee (FPAK). However, AVG is employed for FP below the knee (FPBK), while there is no significant difference in long term patency between reversed vein and in situ vein grafts. Use of heparinized autogenous blood for preparation of AVG is superior to heparinized saline solution in the reendothelialization. The value for ％-area of endothelial cell coverage in the AVGs is 20％ at 2 hours after implantation, whereas 80％ of the area is covered after one week. FPs for diabetic patients with intermittent claudication should be limited because there is a possibility of occurrence of isolated popliteal segment due to disease progression. 5-year primary cumulative patency rates of prostheses for FPAK and AVGs for FPBK are about 70％, justifing the strategy of using vascular prostheses for FPAKs.

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