Limb salvage with CryoVein cadaver saphenous vein allografts used for peripheral arterial bypass: role of blood compatibility.
Patients suffering from limb-threatening ischemia often have scarce or inadequate autogenous veins for complex lower limb revascularization. One option for such patients is to use conduit consisting of cadaver saphenous vein allograft (CSVA) as a final surgical option before limb amputation. This study reviewed retrospectively the patency of CryoVein CSVA allografts, processed by CryoLife, Inc., in 54 implant cases of lower extremity arterial bypass over a span of 6 years. Patient demographics, graft patency, limb salvage, and blood type matching of donor to recipient were analyzed. Kaplan-Meier analysis showed postoperative primary patency rates of 89, 63%, 30%, 17%, and 9% at 1, 3, 6, 12, and 18 months, respectively. Secondary patency rates were 89%, 74%, 63%, 63%, and 54% at 1, 3, 6, 12, and 18 months, respectively. Limb salvage rates were 67% at 12 months and 54% at 18 months. Median follow-up was 467 days. Of the 34 cases where the patient received a blood-group compatible CSVA, 30 had limb salvage and only six of 20 noncompatible grafts offered limb salvage (p = 0.05). Although primary patency rate was poor at 1 year, high secondary patency and limb salvage rates support the use of CSVA as a peripheral bypass conduit alternative. Cases with donor-recipient ABO blood type compatibility had significantly better limb salvage.
Zehr
Bradley P
BP
Indiana/Ohio Heart, Fort Wayne, IN, USA.
Niblick
Charles J
CJ
Downey
Heidi
H
Ladowski
Joseph S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001789:Blood Group Antigens; D001788:Blood Grouping and Crossmatching; D002102:Cadaver; D005260:Female; D006648:Histocompatibility; D006801:Humans; D007196:Indiana; D007511:Ischemia / Q000097:blood / Q000276:immunology / Q000503:physiopathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood / Q000276:immunology / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein / Q000276:immunology / Q000637:transplantation*; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D058017:Vascular Grafting; D014654:Vascular Patency
D001789:Blood Group Antigens