Uruguayan experience with cryopreserved arterial homografts.
BACKGROUND
We analyzed the Uruguayan experience with cryopreserved arterial homografts. We studied 55 medical records in the period from June 9, 2000 to April 7, 2007, including 41 from males and 14 from females, ranging from 36-78 years of age. The clinical indications were as follows: Group 1, revascularization of infrainguinal atherosclerotic occlusive disease by bypass due to the lack of availability of a suitable vein (n = 35); Group 2, substitution of an infected prosthetic grafts (n = 15); and Group 3, arteriovenous fistula (AVF) after failure of previous prosthetic loops by repeated thrombosis and/or infection in the absence of a vein (n = 5).


RESULTS
Among Group 1, primary and secondary patency rates were 61% and 71%, respectively at 1 year with 15 complications, 3 infections, 8 thromboses, 2 aneurysms, 1 homograft degradation, and 1 death related to surgery. Among Group 2, the primary and secondary patency rates were 71% and 79%, respectively, at 1 year with 6 patients experiencing complications. Group 3 did not have complications with a primary patency rate of 67% at 1 year.


CONCLUSIONS
The use of cryopreserved arterial homografts is a valid, accessible, and safe alternative in complicated vascular situations. In our country, it is a technology to consider for patients with critical limb ischemia, when the risk of a major amputation is high and it is not possible to have a suitable vein or prosthetic bypass. It can be an excellent alternative for the substitution of infected synthetic bypasses, especially to substitute in situ for an infected aortic graft.
Esperón
A
A
Area de Cirugía Vascular Periférica, Hospital de Clínicas, Instituto Nacional de Donación y Transplante, Ministerio de Salud Pública, Clinica Quirúrgica 1, Hospital Pasteur. aesperon@chasque.net
Kamaid
E
E
Diamant
M
M
Campos
Héctor Pérez
HP
Del Carmen Saldías
M
M
Icasuriaga
A
A
Varela
C
C
Delgado
D
D
Alvarez
I
I
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001158:Arteries / Q000637:transplantation*; D013504:Cardiovascular Surgical Procedures / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D015925:Cryopreservation / Q000379:methods*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000706:statistics & numerical data*; D014583:Uruguay; D014654:Vascular Patency / Q000502:physiology
D011138:Polytetrafluoroethylene