In terms of long-term graft patency, the best results in the femoral tibial bypass position have been achieved with:

D. Segments of greater and lesser saphenous and cephalic veins spliced together.

DISCUSSION: Particularly for distal bypass grafting, the autogenous saphenous vein is the graft material of choice. When this is not available intact, several segments of this vein, as well as lesser saphenous and upper extremity veins, can be used for creating a graft of sufficient length. When the distal anastomosis is below the popliteal artery autogenous tissue grafts are clearly superior to synthetic ones.