The potentials of the saphenous vein in reconstructive surgery of the arteries--state of the art.

In femoro-popliteal reconstructions proximal to the knee joint alloplastic and heteroplastic material are being used increasingly instead of the autologous vein, even though the latter is still unmatched for quality. The 5-year patency rate of reconstructions with autologous vein in stage III and IV is significantly better compared to that obtained with implanted alloplastic material. It is well worth mentioning that the saphenous vein graft is superior to all other vascular substitutes with regard to morphological qualities and biocompatibility. Even though degenerative changes occur, these can be repaired by surgical procedures in about one third of the cases. In stage III and IV of atherosclerotic occlusive disease of the lower extremity, a more aggressive mode of reconstruction like jump grafts or sequential bypasses significantly improves the long-term results and minimizes the need for extensive amputations.