EARLY RESULTS WITH CRYOPRESERVED SAPHENOUS-VEIN ALLOGRAFTS FOR INFRAINGUINAL BYPASS

Purpose: Cryopreserved saphenous vein allografts (CSVA) are available for use in arterial reconstructions; however, patency rates in the inf rainguinal position are not well described. Methods: We reviewed our e xperience with 38 patients who underwent 43 infrainguinal bypasses wit h CSVA as the conduit. The group includes 21 women and 17 men with a m ean age of 69 +/- 11 years. Mean follow-up is 8.2 +/- 5.5 months. Logi stic regression was used to analyze five variables in an attempt to id entify predictors of success or failure: distal anastomosis to the pop liteal artery versus a crural artery, one-vessel versus two- or three- vessel runoff, postoperative anticoagulation versus none, primary reco nstructions versus reoperations, and one segment versus two segments o f CSVA required. Results:The cumulative patency rate at 12 months by l ife-table analysis is 66%. Logistic regression revealed that primary r econstructions were more likely to succeed than reoperations (p = 0.03 ) and operations completed with one segment of CSVA were more likely t o succeed than those requiring more than one segment of vein (p = 0.03 ). Conclusions: We conclude that (1) the short-term patency of infrain guinal bypasses with CSVA suggests that they may be acceptable alterna tives to prosthetic grafts in the below-knee position, and (2) primary reconstructions performed with one segment of CSVA are more likely to succeed.