Cryopreserved arterial homografts: Preliminary results in infrageniculate arterial reconstructions

The aim of this report is to present our preliminary experience using cryop reserved arterial homografts in below-knee revascularization. We carried ou t a retrospective study at the Public Health Hospital of the Servicio Galeg o da Saude (SERGAS) from October 1995 to March 1997 in which cryopreserved arterial homografts were used for revascularization of 17 lower limbs in 16 patients. The clinical indications were limb-threatening ischemia in 15 lo wer extremities (7 with rest pain and 8 with ischemic ulcers or gangrene), and large aneurysms of femoropopliteal arteries in 2. In addition, 75% of t he patients had undergone previous surgical procedures for revascularizatio n on the involved extremity. No patient had a suitable greater saphenous ve in in the ipsilateral extremity and all patients required a below-knee arte rial reconstruction procedure. There was just one runoff vessel in 11 of 17 extremities (65%). A histological exam was performed in four patients who died (1 case) or had homograft-related complications (3 cases). The results of this study indicated that cryopreserved arterial homografts could be a promising alternative when below-knee revascularization is required in pati ents lacking suitable greater saphenous vein, especially in those with limi ted life expectancy, but despite early acceptable results, many aspects mus t be clarified. Close follow-up is mandatory.