[Clinical study of morphological changes after infragenicular auto-vein bypass operation with Esmarch's bandage method--an investigation by follow-up angiography].

Angiography after infragenicular auto-vein bypass operation with Esmarch's bandage method, in which preparation of the host artery was limited to its anterior wall and Esmarch's rubber bandage was used as a substitute for vascular clamps, was performed in 21 cases (23 extremities) in order to study morphological changes in the grafts, the distal anastomoses and the host arteries. The angiograms showed 1) dilation of the host artery and reduction of the difference between the diameters of the graft and the host artery, 2) smoothing of the angle between the graft and the artery, 3) disappearance of slight irregularities in the graft as well as disappearance of a slight stenosis, 4) no progression of sclerotic change in the distal artery, and 5) preservation of small branches near the distal anastomosis. These findings indicate that the distal anastomoses constructed with this technique were not surrounded by marked scar formation and that their shapes changed favorably to provide smooth blood flow over a long period. This is the reason why infragenicular auto-vein bypass operation was performed with an excellent long-term success using Esmarch's bandage method.