Outcomes After Cadaveric Saphenous Vein Bypass for Limb Salvage: A Single Center Experience
Kuldeep Singh, MD, Tushar Bajaj, MD, Amandeep Juneja, MD, Garry Lacchar, Jonathan Schor, MD, Saqib Zia, MBBS, Jonathan Dietch, MD.
Staten Island University hospital, staten island, NY, USA.
Objective:
Cadaveric saphenous vein (CV) conduits are often used for limb salvage in patients without autogenous veins although long term outcome data is scarce. This study was designed to evaluate the outcomes of CV bypass in patients with critical limb ischemia.
Methods:
We retrospectively reviewed the charts from 2010-2017 of 25 patients who underwent 30 CV allografts for critical limb ischemia. Patient charts were reviewed for demographics, comorbidities, smoking status, indications for bypass, blood loss, and length of hospital stay. Primary outcomes included graft patency, major amputation rates, and mortality. Secondary outcomes measured included infection rates, 30-day MACE and MALE and minor amputations. Statistical analysis was performed using Time Series and Kaplan-Meier estimator.
Results: A total of 30 limbs received a CV bypasses (20 males, 10 female) and the average age was 68 years. MALE occurred in 7(23.3%) patients. Wound infection was seen in 14(46.6%) patients. We had no 30-day myocardial infarctions but 30-day mortality rate was 7(23.3%). Minor amputations (toe or trans metatarsal) were seen in 6(20%) patients. The average graft length was 64.2cm, and average graft diameter was 3.9mm. Primary patency rates were 81%, 58%, 50%, and 32% at 1, 3, 6, and 12 months, respectively. Secondary patency rates were 82%, 63%, 56%, and 41% at 1, 3, 6, and 12 months, respectively. Limb Salvage at 12 months was 68%.
Conclusions: Cadaveric saphenous vein allograft may be used as a bypass conduit as viable surgical option before limb amputation. Despite the poor patency rates, the limb salvage rates of cadaveric vein grafts demonstrate that this alternate conduit may be considered when no autogenous vein is available. 
Back to 2019 ePosters