‘Hitch-hike’ grafts for limb salvage in peripheral arterial disease

Abstract

A technique of arterial reconstruction suitable for patients with extensive arterial occlusions and for previous failed arterial surgery is described. The "hitch-hike" graft consists of a proximal limb of 6-mm velour Dacron prosthesis and a distal limb of autogenous vein. The intermediate prosthesis-to-vein anastomosis is made into an endarterectomized segment of upper popliteal artery. The results in the first 16 limbs are described. Eleven grafts are functioning from 2 to 14 months after operation and 5 of these have functioned for more than 1 year. The advantages of the technique are: long arterial occlusions may be bridged; autogenous vein is used to cross the knee joint; good measured blood flows may be demonstrated at operation; acceptable patency rates may be obtained up to 1 year.

Composite sequential grafts for femorocrural bypass reconstruction: Experience with a modified technique

“…In addition, conjoining the prosthetic and venous anastomosis requires three rather than four lines of suturing and is simpler than the hitch-hike technique of Bliss and Fonseka. 12 Composite sequential bypass reconstruction may be more time consuming initially than use of an all prosthetic graft and requires expertise in distal reconstruction and endarterectomy. The theoretic disadvantage of competitive flow with steal from distal beds by the proximal anastomosis has not been encountered in our experience.…”