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It is well known that patients who require vascular grafting of arteries below the inguinal, or groin, region have a better outcome when the saphenous vein of the leg is used as the graft conduit, rather than synthetic graft material. When the saphenous vein can not be used, good results have been obtained using other veins, such as the short saphenous vein, an arm vein or even a deep leg vein. The advantages of using the patient's own vein as a conduit are even greater when a vein, rather than an artery, is being replaced. If a vein is to replace another vein, the caliber (size of the lumen, or internal diameter) of the vessels must match. Large veins, such as the vena cava, may be replaced by using deep leg veins, such as the superficial femoral-popliteal vein in the thigh-knee area. This procedure has not gained widespread acceptance because of fear of restricting the venous outflow from the donor leg. A study was undertaken to evaluate the effects of excision of a deep leg vein in two groups of patients: 21 patients (25 legs) underwent femoropopliteal arterial bypass using the femoral-popliteal vein; 19 patients (22 legs) had the same bypass operation performed, except that synthetic graft was used and the femoral-popliteal vein was left intact (control group). Patients were evaluated after surgery both clinically and functionally. The legs that had been vein donors showed a small, but significant increase in average calf diameter compared with the control group. This was the only sign or symptom of chronic venous stasis. Venous outflow obstruction was shown on X-ray study of the veins in 21 of 25 vein donor legs (84 percent), compared with only 50 percent of the control legs. However, symptomatically the vein donor patients were not statistically different from the control group; three months after surgery 40 percent of the donor group and 40.9 percent of the control group complained of swelling. These results suggest that the deep veins of the leg may be considered for use as arterial grafts if superficial veins are not available. (Consumer Summary produced by Reliance Medical Information, Inc.)