Background: We evaluated the results of infrainguinal femoropopliteal bypass operations.

Methods: Thirty-seven patients (30 males, 7 females; mean age 61 years; range 21 to 82 years) were retrospectively evaluated. Clinical results and graft patencies were determined.

Results: Distal anastomoses were placed at the level of popliteal artery trifurcation in 28 patients (75.7%), to the tibioperoneal trunk in one patient (2.7%), posterior tibial artery in four patients (10.8%), and anterior tibial artery in four patients. Reversed autogenous saphenous vein was used in 28 patients and polytetrafluoroethylene graft was used in nine patients. All patients receiving a synthetic graft were treated with anticoagulants. Mortality did not occur. Thrombectomy was performed in seven patients (18.9%) due to graft failure. One-year patency rate was 89.3% with autogenous saphenous veins, and 55.6% with synthetic grafts (p<0.05). Two major (5.4%) and three minor (8.1%) amputations were required.

Conclusion: Reversed autogenous saphenous vein should be the graft of choice in below-knee bypass operations. Adjuvant anticoagulant therapy may improve the patency rate in patients receiving a synthetic graft.

Keywords : Femoral artery/surgery; peripheral vascular diseases/ surgery; popliteal artery/surgery; saphenous vein/transplantation; vascular patency; vascular surgical procedures