Long-term results with vein homograft in femoro-distal arterial reconstructions.
There still is a need for an alternative to autologous vein especially for infra-inguinal vascular reconstructions. Since 1984 we have used a denatured venous homograft in patients in whom the saphenous vein was either absent or unsuitable. One hundred and five homografts were implanted in the femoro-popliteal and 51 in the femoro-infrapopliteal position. The results obtained were satisfactory, with a 5-year cumulative patency (life-table method) of 53% overall, 68.4% in patients with disabling claudication, and 42% in those with critical ischaemia. The cumulative aneurysm rate was rather high, at 18% after 3 years and 58% after 5 years. An excellent limb salvage rate of 85% was achieved in patients with critical ischaemia. The management of graft aneurysms and the indications for reconstructive surgery with a denatured venous homograft are discussed.
van Reedt Dortland
R W
RW
Department of Surgery, University Hospital, Utrecht, The Netherlands.
van Leeuwen
M S
MS
Steijling
J J
JJ
Theodorides
T
T
van Vroonhoven
T J
TJ
D000368:Aged; D000369:Aged, 80 and over; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D011474:Prosthesis Design; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography