The significance of vein wall thickness and diameter in relation to the patency of femoropopliteal saphenous vein bypass grafts.

Two hundred and twenty-five reversed saphenous vein femoropopliteal bypass graft procedures were performed on 186 patients with occlusive vascular disease. These grafts were followed for a mean of 19 months, with the longest period being 64 months. Numerous factors ascertained before, during, and after operation were analyzed using a life-table technique to see how these factors correlated with graft patency. The internal diameter and wall thickness of the vein grafts appeared to significantly influence graft patency. The best results were obtained using veins with a large internal diameter and a thin wall. In contrast, none of the other factors studied (which included age, sex, blood pressure, height, weight, indication for surgery, diabetic state, serum lipids, angiographic data, the site of the upper and lower anastomoses, the use of spliced vein segments, the type of vein preparation and the consumption of cigarettes before operation) were useful predictors of graft patency. It is suggested that vein diameter and vein wall thickness should be taken into consideration when analyzing the results of saphenous vein femoropopliteal bypass graft procedures, and also that the assessment of these factors may influence the choice of graft material for a femoropopliteal bypass graft.