endarterectomy. these procedures are used when possible as they are considered to be minimally invasive, in turn reducing recovery time and possible complications post-surgery. history historically, the first incidence of using a vein to bypass a femoral artery was in 1948 to treat a patient suffering from a foot ulcer. although the bypass technique was not a new discovery, it was not yet widely used and known. in 1962, a new surgical technique, otherwise known as the in situ procedure was developed and used on veins to improve bypass. it works by increasing the radius of the vein to increase blood flow along the blood vessel. today, it has now been proved that the in situ procedure is better suited in vein bypasses in the lower leg compared to the upper leg, particularly for treating advanced ischemic disease in the lower leg.