Use of the short saphenous vein in situ for popliteal-to-distal artery bypass

In the absence of a usable greater saphenous vein, the short saphenous vein has been relatively ignored for use as an arterial bypass conduit. In 36 patients, duplex ultrasound scanning was used for preoperative assessment of the short saphenous vein. The internal diameter of the vein ranged from 2.8 to 4.2 mm. The short saphenous vein was harvested for a free vein graft in 31 patients. In the remaining five patients, the short saphenous vein was used in situ for popliteal-to-distal artery bypass. In four patients, the distal anastomosis was performed to the distal anterior tibial artery and in one patient, to the distal posterior tibial artery. Valves were excised with valvulotomes and deep fistulas were easily ligated. A medial incision for vein exposure was the preferred approach. We suggest that the short saphenous vein be considered more often for use as an arterial bypass conduit when the greater saphenous vein is not available, before submitting to nonautogenous bypass or primary amputation.