Femoropopliteal bypass grafting for intermittent claudication: is pessimism warranted?

From 1965 to 1979, 43 consecutive patients underwent 51 femoropopliteal reconstructions to relieve disabling claudication. This represented 17% of 298 femoropopliteal and femorotibial reconstructions performed by the same surgical team during this period of time. All patients operated on for claudication experienced relief of symptoms after surgery. There was no operative mortality and there was only one case of immediate graft failure. Cumulative graft patency was 93% at two years and 88% at five years by life table analysis. One patient who underwent below-knee amputation 12 years after his initial femoropopliteal graft was the only patient who lost a limb at any time during the follow-up period. On the basis of this experience, we now offer femoropopliteal grafting to any active individual who is disabled by intermittent claudication on the basis of superficial femoral artery occlusive disease.