SOME CONTROVERSIAL TOPICS IN VASCULAR SURGERY

Although the surgical procedures used in the treatment of vascular disease have gradually become more standardized over the past few years, variations continue to exist in surgical indications and in the preferences for surgical technic. Three problems in whose management some differences of opinion can still be found are discussed, and the reasons for the author's choice of treatment are as follows: (1) The use of autogenous (saphenous) vein graft as a bypass from groin to calf is favored in the treatment of femoropopliteal occlusive disease. (2) In aortoiliac occlusive involvement, bypass grafting with a Helanca-Dacron prosthesis is preferred since its ten year results are at least as good as those with endarteriectomy and it has a much wider applicability. (3) An aggressive attitude is advocated in the treatment of asymptomatic abdominal aortic aneurysms; neither small size nor advanced age is judged to contradict surgical treatment as long as the patient's physiologic state is good enough to support aneurysmectomy. © 1969.