The Below- Knee Transposition of a Vein Bypass— A New Therapeutic Principle

Abstract

The autologous femoro-popliteal vein bypass is a proven treatment concept for the correction of the chronical, and more seldom, of the acute arterial occlusion with good long-term results. 1,2 Recurrent operations show a clearly worse prognosis than the first opera tion. The reasons are the technical difficulties of the revision, the absence of an autologous vessel graft and the less favourable prognosis of the lengthy desob literation, which is recommanded by certain authors as second operation.3,4 The pseudo-recurrent occlusion represents a rather rare indication for a new opertion. Because of an obliteration of the outflow artery, it is considered clinically and oscillographically as a recurrent occlusion. Only the direct Doppler-ultrasound-sonography or the angiography show the patency of the primary bypass, which can flow through small collateral vessels or backward over the distal anastomosis. This paper is meant to be a contribution to the operative treatment of this occlusion kind in case of missing autologous graft after a short femoro-popliteal vein bypass.