Which of the following adversely influence the patency of lower extremity autogenous vein grafts?

A. Poor arterial outflow from the distal anastomosis of the graft.

C. Small-caliber (less than 4 mm. in diameter) veins.

E. Grafts performed for limb salvage indications rather than claudication.

DISCUSSION: Small-caliber veins perform poorly as arterial substitutes. The long-term patency of infrainguinal vein grafts is better when the indication for operation is claudication rather than limb salvage and is improved when there is a good outflow tract. Reverse vein and in situ bypass have equal patency rates at all levels. Surprisingly, the presence of diabetes has not been shown to negatively affect the patency of autogenous vein infrainguinal arterial bypass.