Cryopreserved arterial allografts for limb salvage in the absence of suitable saphenous vein: two-year results in 20 cases.
From January 1992 to November 1992, 20 cryopreserved arterial allografts were used as below-knee bypasses for repeated limb salvage in 18 patients lacking saphenous vein grafts. Arteries were obtained during multiorgan harvesting. A scheduled program of cryopreservation with 15% dimethylsulfoxide was used. Mean storage period was 37 days. All cases were matched for blood group compatibility. Patency was checked at 10 and 90 days and twice a year thereafter. Conventional arteriography was routinely performed 3 months postoperatively. Average follow-up was 26.8 months for the 18 patients and 20.8 months for the 20 bypass grafts. No patients were lost to follow-up. Aneurysmal dilation developed in one graft, which was replaced by another homograft. During follow-up 10 grafts occluded: five once, four twice, and one four times. These 10 grafts underwent a total of 16 reinterventions. Thrombectomy with angioplasty was performed 15 times and graft replacement once because of proximal and distal arterial deterioration. Primary actuarial patency was 68% at 1 year and 42% at 2 years. Secondary actuarial patency was 89% at 1 year and 72% at 2 years. Preliminary results of cryopreserved arterial allografts for repeated limb salvage in the absence of available saphenous veins are encouraging. Further studies are needed to determine the long-term deterioration rate of cryopreserved arterial allografts.
Gournier
J P
JP
Service de Chirurgie Cardio-Vasculaire, CHU de Saint Etienne, France.
Favre
J P
JP
Gay
J L
JL
Barral
X
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001158:Arteries / Q000637:transplantation*; D015925:Cryopreservation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011446:Prospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014654:Vascular Patency
D011138:Polytetrafluoroethylene