Ten Year Experience With Cryopreserved Superficial Femoral Artery And Great Saphenous Vein Conduits For Infra-inguinal Bypass
Bryce French, MD, Danielle Hayes, MD, Shelby Reiter, MD, Kaj Johansen, MD PhD, Swee Lian Tan, MD PhD.
Swedish Medical Center, Seattle, WA, USA.
INTRODUCTION AND OBJECTIVES:
Cryopreserved superficial femoral artery (SFA) or great saphenous vein (GSV) are alternatives to prosthetic grafts in patients lacking suitable autogenous veins for bypass. Our study aims to assess patency rates of cryopreserved vessels used in infra-inguinal bypass at our institution.
METHODS:
Cases in which cryopreserved SFA or GSV were used for infra-inguinal bypass at our institution were reviewed from 2008-2018. Each case was analyzed for proximal and distal anastomotic site, primary patency, primary assisted patency, type of conduit used, limb salvage, primary or second cryopreserved graft, Rutherford score limb salvage and mortality during the study period.
RESULTS:
117 infra-inguinal bypasses with cryopreserved SFA or GSV were identified. Above knee popliteal bypass had higher primary assisted patency at one year, than bypasses with a below knee distal anastomosis (85% vs. 63%). However, at three years the primary assisted patency rates were similar in the two groups (63% vs. 61%). There was a trend toward higher primary patency (42% vs. 26%) and primary assisted patency (73% vs. 54%) at one year in below knee popliteal anastomosis compared to tibial artery or peroneal artery distal anastomosis. Limb salvage was higher in above knee bypasses compared to below knee bypasses (83% vs. 62%). When a cryopreserved SFA was used as the conduit versus GSV there was a trend towards increased primary assisted patency rates at one year (SFA 73%, GSV 59%) and three years (SFA 78%, GSV 47%).
CONCLUSIONS:
Our results highlight that cryopreserved vessels have patency rates comparable with those previously published for prosthetic bypass conduits. When choosing a cryopreserved vessel, SFA demonstrates higher patency rates than GSV. As with other bypasses, the more proximal the distal anastomosis, the higher the patency and limb salvage rates.
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