title: Sequential femorodistal composite bypass with second generation glutaraldehyde stabilized human umbilical vein (HUV).
abstract: OBJECTIVE
  To evaluate the performance of sequential composite bypasses with second generation glutaraldehyde stabilized human umbilical vein (HUV) and autologous vein.
  
  
  METHODS
  Retrospective study of consecutive patients, in a single centre.
  
  
  METHODS
  From January 1998 to December 2003, 54 femoro-distal HUV-autologous vein sequential composite bypasses were constructed in 52 patients with critical leg ischemia and absence of sufficient length of autologous vein.
  
  
  METHODS
  All infra-inguinal bypass operations were registered in a computerized database and prospectively followed. Bypasses using sequential HUV-composite technique were reviewed for graft patency, limb salvage and patient survival.
  
  
  RESULTS
  Primary patency and secondary patency rates at 1, 2, 3 and 4 years were 71, 61, 53 and 53% and 89, 80, 73 and 67%, respectively. Corresponding limb salvage rates were 96, 92, 88 and 88%. Patient survival was 56% at 4 years. After 30 days additional procedures to maintain graft patency were necessary in six bypasses. Asymptomatic occlusion of one sequential anastomosis was found in five patients.
  
  
  CONCLUSIONS
  Graft patency and limb salvage rate support the use of the sequential composite technique with second generation HUV in femorodistal bypass surgery, when autologous vein of sufficient length is not available.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Johannes Gutenberg University School of Medicine, Mainz, Germany. neufang@mail.uni-mainz.de
authors.forename: A
authors.initials: A
authors.lastname: Neufang
authors.forename: C
authors.initials: C
authors.lastname: Espinola-Klein
authors.forename: B
authors.initials: B
authors.lastname: Dorweiler
authors.forename: J
authors.initials: J
authors.lastname: Reinstadler
authors.forename: M
authors.initials: M
authors.lastname: Pitton
authors.forename: S
authors.initials: S
authors.lastname: Savvidis
authors.forename: R
authors.initials: R
authors.lastname: Fischer
authors.forename: C
authors.initials: C
authors.lastname: Vahl
authors.forename: W
authors.initials: W
authors.lastname: Schmiedt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014471:Umbilical Veins / Q000637:transplantation*