VEIN GRAFTs+ SYNTHETIC GRAFTs = Composite graft
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Non availability of the long saphenous vein grafts for the long segment Femoro-popliteal bypass in the legs with distal anastomosis below the knee is common. The great saphenous vein is many times not suitable for the bypass surgery as its size is less than 4 mm in diameter in all its length and there can be branching of great saphenous vein. We do not have Indian data on the suitability of vein grafts for Femoro-popliteal bypass. We do not want to place the synthetic grafts across the knee joints due to the fear early thrombosis. Composite grafts ( half synthetic grafts and half vein grafts) are probably best suited for the Femoro-distal bypass in such cases.

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