Small arterial reconstruction using modified cadaveric saphenous veins.
Human saphenous veins removed from cadaver donors were subjected to proteolytic enzymatic digestion, cross bonding, and heparin bonding. They were tested as small arterial substitutes in dogs. Eight of eleven were successful, persisting without development of stenosis or aneurysm, the longest for eighteen months. In humans, similarly prepared veins were used as arterial bypasses to revascularize ischemic limbs in eleven patients and aneurysmal degeneration of an earlier unmodified allograft bypass in one patient. Distal arterial anastomoses were to the tibial and peroneal arteries. Nine patients who had not undergone previous reconstructive surgery involving the vessel used for distal anastomosis were treated successfully; all remain with healed limbs between three and twelve months after surgery, eight with functioning bypasses. In three patients who had undergone previous operations on the same artery used for distal anastomosis, long bypasses failed, although amputation was avoided in one patient by additional bypass with modified vein to the profunda femoris artery. We conclude that modified saphenous vein allografts are suitable small arterial substitutes. It remains to be seen whether veins will maintain patency for long periods without development of complications.
D000368:Aged; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery; D001158:Arteries / Q000601:surgery*; D002102:Cadaver; D004285:Dogs; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000473:pathology / Q000637:transplantation*; D014183:Transplantation, Heterologous; D014184:Transplantation, Homologous