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Angiología
On-line version ISSN 1695-2987Print version ISSN 0003-3170
Abstract
TAPIA-LOPEZ, Yolanda; RODRIGUEZ-GONZALEZ, Carmen and GONZALEZ-FAJARDO, José A. Distal bypass in situ. Angiología [online]. 2023, vol.75, n.2, pp.97-100. Epub May 01, 2023. ISSN 1695-2987. https://dx.doi.org/10.20960/angiologia.00418.
Distal revascularization of the lower extremities was always a source of controversy in the 1980s among those who advocated reverse saphenous vein bypass versus in situ saphenous vein bypass, although the late results demonstrated that both approaches were similar. The important fact was the substitute material (the autologous vein) and the revascularization technique of the vascular surgeon.
The in-situ bypass allowed an anatomical position without produces caliber disparity in the proximal and distal vascular anastomoses, avoiding the risk of twisting. It is true that it carried secondary risks such as the persistence of arteriovenous fistulas and the inherent need to tear the venous valves. Various methods were used over time, but eventually Lemaitre's valvulotome established itself as one of the safest. The authors of this article describe how they do it and point out the critical points to optimize the result, although they are aware that there will be variations between surgical groups, but maintaining the essence of the procedure.
Keywords : Saphenous vein bypass; In-situ bypass.