Ten Year Experience of Using Cryopreserved Arterial Allografts for Distal Bypass in Critical Limb Ischaemia.

Details

Serval ID
serval:BIB_8E4B2BACE434
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ten Year Experience of Using Cryopreserved Arterial Allografts for Distal Bypass in Critical Limb Ischaemia.
Journal
European journal of vascular and endovascular surgery
Author(s)
Masmejan S., Deslarzes-Dubuis C., Petitprez S., Longchamp A., Haller C., Saucy F., Corpataux J.M., Déglise S.
ISSN
1532-2165 (Electronic)
ISSN-L
1078-5884
Publication state
Published
Issued date
06/2019
Peer-reviewed
Oui
Volume
57
Number
6
Pages
823-831
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
In critical limb ischaemia (CLI), current guidelines recommend revascularisation whenever possible, preferentially through endovascular means. However, in the case of long occlusions or failed endovascular attempts, distal bypasses still have a place. Single segment great saphenous vein (GSV), which provides the best conduit, is often not available and currently there is no consensus about the best alternative graft.
From January 2006 to December 2015, 42 cryopreserved arterial allografts were used for a distal bypass. Autologous GSVs or alternative autologous conduits were unavailable for all patients. The patients were observed for survival, limb salvage, and allograft patency. The results were analysed with Kaplan-Meier graphs.
Estimates of secondary patency at one, two and five years were 81%, 73%, and 57%, respectively. Estimates of primary patency rates at one, two and five years were 60%, 56%, and 26%, respectively. Estimates of limb salvage rates at one, two and five years were 89%, 89%, and 82%, respectively. Estimates of survival rates at one, two and five years were 92%, 76% and 34%, respectively. At 30 days, major amputations and major adverse cardiac events were one and zero, respectively. Six major amputations occurred during the long-term follow up.
Despite a low primary patency rate at two years, the secondary patency of arterial allografts is acceptable for distal bypasses. This suggests that cryopreserved arterial allografts are a suitable alternative for limb saving distal bypasses in the absence of venous conduits, improving limb salvage rates and, possibly, quality of life.
Keywords
Adult, Aged, Aged, 80 and over, Allografts, Amputation, Arteries/transplantation, Critical Illness, Cryopreservation, Female, Graft Occlusion, Vascular/etiology, Graft Occlusion, Vascular/physiopathology, Graft Occlusion, Vascular/surgery, Humans, Ischemia/diagnostic imaging, Ischemia/physiopathology, Ischemia/surgery, Limb Salvage, Lower Extremity/blood supply, Male, Middle Aged, Reoperation, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Vascular Grafting/adverse effects, Vascular Grafting/methods, Vascular Patency, Allograft, Critical limb ischaemia, Distal bypass
Pubmed
Web of science
Create date
14/06/2019 17:28
Last modification date
21/08/2019 6:34
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