Allograft vein bypass: Is it an acceptable alternative for infrapopliteal revascularization?

Harris, Robert W.; Schneider, Peter A.; Andros, George; Oblath, Robert W.; Salles-Cunha, Sérgio X.; Dulawa, Leo

doi:10.1016/0741-5214(93)90064-s

Cited by 54 publications

(23 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 1993, Walker et al 9 concluded that CHg offered better results than a synthetic conduit, but its use should be deferred until improved preparation techniques could provide a more durable conduit. Similarly, Harris et al 10 obtained similar unexciting results.…”

Section: Discussionsupporting

confidence: 68%

Treatment of Popliteal Artery Aneurysms by Means of Cryopreserved Homograft

Mezzetto

Scorsone

Pacca

et al. 2015

Annals of Vascular Surgery

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 68%

Treatment of Popliteal Artery Aneurysms by Means of Cryopreserved Homograft

Mezzetto

Scorsone

Pacca

et al. 2015

Annals of Vascular Surgery

View full text Add to dashboard Cite

“…[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Comparison was made difficult because these grafts were used for different indications (some for replacement of infected grafts) and because different methods of harvesting, preservation, and immunosuppressive therapy were used. Through careful graft selection, meticulous immunosuppressive therapy with cyclosporine, and careful follow-up, we could obtain 1-year secondary patency comparable with the best published results.…”

Section: Discussionmentioning

confidence: 99%

Fifteen years of infrapopliteal arterial reconstructions with cryopreserved venous allografts for limb salvage

Randon

Jacobs

Ryck

et al. 2010

Journal of Vascular Surgery

View full text Add to dashboard Cite

Objective: The availability of autologous vein grafts remains the limiting factor in infragenual bypass surgery in many patients with critical limb ischemia (CLI). Alternatives such as prosthetic conduits are known to have a poor outcome and most are not resistant to infection. Based on previous experimental work, we started to use cryopreserved saphenous vein allografts for this indication 15 years ago. To evaluate their outcome, we performed a retrospective study of those bypasses with distal anastomosis on a crural or pedal vessel. Methods: Between November 1991 and December 2005, 108 cryopreserved great saphenous vein allografts were implanted for in 92 patients (42 women, 50 men) with a mean age of 71 years (range, 39-88 years). All patients received low-dose immunosuppressive therapy for up to 1 year after intervention. Follow-up was conducted until amputation, death, or the end of the study in March 2007. Results: Nondiabetic atherosclerosis the cause of CLI in 57%, 41% had diabetes, and 2% had Buerger disease. Forty-one conduits were performed for primary reconstructions and 67 for redo reconstructions. During a mean follow-up of 26.4 months, 69 occlusions occurred. Primary and secondary patency rates were 56% and 73% at 1 year, 32% and 60% at 3 years, and 17% and 38.5% at 5 years. Survival rates were 87.4% at 1 year and 64.5% at 5 years. At multivariate analysis, the intake of statins was predictive for improved patency (hazard ratio [HR], 0.09; P = .024) and for prolonged survival (HR, 0.335; P = .045). The presence of diabetes showed a trend for inferior patency (HR, 2.325; P = .116) and for decreased amputation risk (HR., 0.592; P = .078). Conclusion: Cryopreserved saphenous vein allografts are a valuable alternative to prosthetic materials when autologous veins are not available. Our limb salvage and patency rates are higher then those described for prosthetic grafts at the infrapopliteal level in most studies. Moreover, these grafts are resistant to infection when performed for revascularization in patients with an infected ulcer. Better graft and patient selection, better graft surveillance and immunologic matching, and standard use of statins could possibly improve the results even further. Shortage in availability might be a limiting factor for their widespread use

show abstract

“…The infra-popliteal artery to paramalleolar artery bypass has expanded its use because infrapopliteal arterial occlusive disease is the predominant pattern seen in diabetes requiring revascularization and because the prevalence of diabetes and the indications for diabetic interventions arerising dramatically.Like the longer bypasses to the foot, they must be constructed of autogenous vein. Homograft GSV has been advocated but have not been able to achieve durable patency expected with autogenous grafts (17,18). The argument over the superiority of reversed versus nonreversed versus in situ bypass was investigated and most surgeons now agree that all three are equivalent (19).…”

Section: Femoro-popliteal Bypassmentioning

confidence: 98%

“…Like the longer bypasses to the foot, they must be constructed of autogenous vein. Homograft GSV has been advocated but have not been able to achieve durable patency expected with autogenous grafts (17, 18). The argument over the superiority of reversed versus nonreversed versus in situ bypass was investigated and most surgeons now agree that all three are equivalent (19).…”

Section: Infra-inguinal Bypassmentioning

confidence: 99%

Bypass Grafts: The State of the Art

Andros

Lee

2012

Scand J Surg

View full text Add to dashboard Cite

The treatment options for infra-renal arteriosclerotic occlusive (ASO) vascular disease have never been more varied. The history of open revascularization procedures now exceeds 60 years. This represents three generations of vascular surgeons, the most recent of whom have witnessed more than 30 years of endovascular surgery development and dissemination. Both open and endovascular treatments should be considered mature; moreover, we are improving our understanding of the strategies and tactics that lead to the clinical application of one approach instead of the other. There are other important factors in the choice of a treatment modality to be used for a specific patient. Prime among these is evolving patterns of occlusive disease and the increasing severity of arterial calcification.

show abstract

Allograft vein bypass: Is it an acceptable alternative for infrapopliteal revascularization?

Cited by 54 publications

References 29 publications

Treatment of Popliteal Artery Aneurysms by Means of Cryopreserved Homograft

Treatment of Popliteal Artery Aneurysms by Means of Cryopreserved Homograft

Fifteen years of infrapopliteal arterial reconstructions with cryopreserved venous allografts for limb salvage

Bypass Grafts: The State of the Art

Contact Info

Product

Resources

About