CRYOPRESERVED ARTERIAL ALLOGRAFTS FOR LIMB SALVAGE IN THE ABSENCE OF SUITABLE SAPHENOUS-VEIN - 2-YEAR RESULTS IN 20 CASES

From January 1992 to November 1992, 20 cryopreserved arterial allograf ts were used as below-knee bypasses for repeated limb salvage in 18 pa tients lacking saphenous vein grafts. Arteries were obtained during mu ltiorgan harvesting. A scheduled program of cryopreservation with 15% dimethylsulfoxide was used. Mean storage period was 37 days. All cases were matched for blood group compatibility. Patency was checked at 10 and 90 days and twice a year thereafter. Conventional arteriography w as routinely performed 3 months postoperatively. Average follow-up was 26.8 months for the 18 patients and 20.8 months for the 20 bypass gra fts. No patients were lost to follow-up. Aneurysmal dilatation develop ed in one graft, which was replaced by another homograft. During follo w-up 10 grafts occluded: five once, four twice, and one four times. Th ese 10 grafts underwent a total of 16 reinterventions. Thrombectomy wi th angioplasty was performed 15 times and graft replacement once becau se of proximal and distal arterial deterioration. Primary actuarial pa tency was 68% at 1 year and 42% at 2 years. Secondary actuarial patenc y was 89% at 1 year and 72% at 2 years. Preliminary results of cryopre served arterial allografts for repeated limb salvage in the absence of available saphenous veins are encouraging. Further studies are needed to determine the long-term deterioration rate of cryopreserved arteri al allografts.