Dacron vs vein for femoropopliteal arterial bypass. Should the saphenous vein be spared?

The increasing need for the saphenous vein to bypass lesions of the coronary and other small arteries prompts a reconsideration of its routine use for femoropopliteal bypass. Evaluation after five years in 124 consecutive patients (135 procedures) demonstrated no significant difference in overall definitive patency between venous grafts (63%) and Dacron prostheses (65%). Dacron prostheses were avoided when below-knee anastomoses were required, but when the distal anastomoses were made above the knee, the five-year patency for veins and Dacron was equal (67%). Although the quality of the distal runoff influenced the long-term patency, effects were similar for veins and for Dacron. The data support the use of Dacron prostheses for femoropopliteal bypass proximal to the knee joint, allowing preservation of the saphenous vein for possible use elsewhere.