Short vein grafts in limb-saving arterial reconstructions.

In the management of limb-threatening infrainguinal arteriosclerosis, the short vein graft is a feature of distal-origin bypass procedures from the superficial femoral and popliteal arteries to more distal arteries. These procedures, which can only be performed in selected patients, have patency rates equivalent to those of comparable bypasses from the common femoral artery. Other advantages include the increased availability of the shorter vein graft segment that is required. Two newer operations that use short vein grafts are tibio-tibial bypasses and bypasses to isolated segments of infrapopliteal arteries. The authors' initial experience with these two procedures includes encouraging patency and limb salvage rates for periods up to 2 years in patients for whom there was no other therapeutic option short of amputation.