Availability of the Great Saphenous Veins as Conduits for Arterial Bypass Surgery in Patients with Varicose Veins.

The great saphenous vein (GSV) has long been recognized as the best conduit for vascular bypass procedures. Concomitant varicose veins disease may be a reason for GSV unavailability either due to dilatation and tortuosity of the vein or due to its destruction during invasive venous treatment. -to assess the rate of varicose vein patients with concomitant lower extremity arterial disease (LEAD) who have previously lost their GSV due to venous ablation. A total of 285 patients (76 F, 209 M) with LEAD were consecutively enrolled. A total of 111 patients (222 limbs) underwent a detailed duplex ultrasound of the lower extremity veins for assessing suitability of the GSV as a conduit. We registered presence of varicose veins (VVs), type of previous invasive procedure and availability of saphenous veins as possible grafts. The mean age of screened patients was 70.5 ± 9.1.62 (21.75%) patients had varicose veins or were operated on before due to varicose veins. A total of 42 patients with varicose veins had C2 disease, 10 had C3, 9 had C4 and 1 had C6 according to CEAP classification. A total of 222 lower extremities were examined by duplex ultrasound of which 51 limbs had VVs. Despite the presence of varicose tributaries, the GSV was suitable for bypass in 9 of those lower extremities. The GSV was not available as a conduit in 34 (19.9%) ipsilateral lower extremities in the LEAD with no VVs group and in 42 (82.6%) ipsilateral lower extremities in the LEAD with VVs group ( = 0.0001). Varicose vein disease was associated with a higher frequency of the GSV unavailability (odds ratio 18.8, 95% confidence interval 8.35-42.35). On the 11 ipsilateral limbs (5% of LEAD patients and 21.6% of LEAD with VVs patients), the GSV was unavailable due to previous venous interventions. Almost 20% of patients may have both LEAD and VVs. Among those with VVs, most have the ipsilateral GSV unavailable as a potential conduit. Additionally, one fifth of limbs with VVs had GSVs destroyed previously due to saphenous ablative procedures.