Sequential femoropopliteal and femorotibial bypasses. A ten-year follow-up study.

Since 1970, we have performed 33 sequential femoropopliteal bypass grafts (of 482 femoropopliteal bypasses [7%]) and 22 sequential femorotibial bypass grafts (of 153 femorotibial bypasses [14%]). Patients ranged in age from 51 to 90 years. Twenty-two (66%) of the sequential femoropopliteal bypass grafts, and all of the sequential femorotibial bypass grafts, were for limb salvage. By life table analysis, interval patency rates for both types of sequential procedures at 60 months, 72 months, and even longer are good (greater than 80% for both sequential femoropopliteal and sequential femorotibial bypasses). These two sequential bypasses are effective alternatives when the saphenous vein is inadequate. We assume that these results are due to excellent inflow (using a prosthetic graft proximally) and the use of a segment of autogenous saphenous vein over the knee joint.