| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 5994104 | Journal of Vascular Surgery | 2014 | 6 Pages |
ObjectiveAutogenous saphenous vein is the ideal conduit for lower extremity revascularization. Unfortunately, autogenous vein is unavailable in up to 20% of patients. Synthetic grafts provide an alternative; however, their use in distal revascularization has shown varying results. In addition, infected surgical sites preclude their use. Currently, there are limited outcome data for cryopreserved saphenous vein use in regard to long-term patency and limb salvage rates.MethodsCryopreserved saphenous vein allograft use in infrainguinal bypass was studied retrospectively in a community setting. End points included primary patency, limb salvage, and early complications. Records of patients receiving cryopreserved allografts by nine vascular surgeons within one hospital system from 2006 to 2012 were reviewed.ResultsFifty-three patients, mean age 69Â years (standard deviation, 12.3; range, 28-90Â years), underwent 60 operations. Indications for surgery included limb-threatening ischemia (48%), tissue loss (30%), previous graft or site infection (10%), claudication (7%), or other (5%). The mean follow-up period was 23.9Â months (standard deviation, 21.0; range, 0-64Â months). Primary patency was maintained in 53% of patients at 1Â year and in 22% at 3Â years. Limb salvage was achieved in 74% of patients at 1Â year and in 70% at 2Â years. Thirteen early complications included 8 thromboses, 2 deaths, 2 amputations, and 1 anastomotic disruption. Fifteen patients (28%) underwent additional ipsilateral operations with use of synthetic conduits after initial cryopreserved allografts failed.ConclusionsCryopreserved vein allografts displayed poor short-term and long-term patency, whereas limb salvage rates at 1 and 2Â years remained acceptable. However, >25% of patients required additional ipsilateral operations with use of synthetic conduits after previous failed cryopreserved allograft use. Our data indicate that cryopreserved vein graft is a suboptimal choice of conduit in a noninfected field.
