A femoro-popliteal bypass graft is the favoured treatment for occlusive disease of the superficial femoral artery. Usually, the patient's own long saphenous vein is used for the graft, a technique known as autogenous bypass grafting.
Conventionally, the vein is dissected out from the groin to the knee, and its tributaries ligated. The vein is then reversed, so that the valves do not obstruct the blood flow, and joined to the common femoral artery above and the popliteal below.
A more recent approach is to leave the vein in situ and to destroy its valves with a wire device known as a valvulotome. The major advantage with this method is that the natural taper of the vein is preserved.
Synthetic graft materials are used when no suitable vein is available but are associated with a higher thrombotic rate.
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