Substituting a cryo-preserved cadaveric vein or an in situ or reversed vein graft from the patient for an arterial bypass graft is an option for patients who have healthy,easily accessed saphenous veins.How does an in situ vein graft differ from a reversed vein graft?

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Two methods of grafting veins are the in situ graft and the reversed vein graft.The in situ method leaves the vein in its place,side branches are ligated to prevent arteriovenous fistulas,and the valves that would impede arterial flow are disrupted with instruments specifically designed to cut valves,called valvulotomes.Autogenous vein grafting for infrainguinal bypass is considered the criterion standard.Reoperation is more frequent with the in situ method because of missed valves and residual arteriovenous fistulas.Reversal of a vein graft is performed per the surgeon's preference or when it must be harvested from the contralateral limb.

Substituting a Cryo-Preserved Cadaveric Vein or an in Situ or Reversed