Saphenous neuralgia and limb edema after femoropopliteal artery by-pass.

One hundred thirty-one limbs of 109 patients who underwent femoropopliteal artery by-pass were studied for postoperative saphenous neuralgia and limb edema. The following factors were analyzed: age, sex, underlying disease (arteriosclerosis obliterans or Buerger's disease), grade of symptoms (Fontaine's classification), presence of diabetes mellitus, the site of distal anastomosis (above or below the knee), vascular graft material (reversed saphenous vein, expanded polytetrafluoroethylene or composite), presence of postoperative hematoma, and levels of serum creatinine and albumin 3 weeks after surgery. To examine limb edema, radioisotope (RI) venography and RI lymphography were performed. Saphenous neuralgia occurred in 22 limbs (16.8%) and limb edema in 27 limbs (20.6%). None of the factors examined was found to be significantly associated with saphenous neuralgia. The risk of developing limb edema was higher in diabetic patients and in patients in whom the distal anastomosis was performed below the knee. Although no case of limb edema was associated with signs of obstruction on RI venogram, 80% of the cases showed lymphatic obstruction on RI lymphograms.