CRYOPRESERVED ALLOGRAFTS FOR LIMB SALVAGE

Over a nineteen-month period, 17 patients (8 men, 9 women) underwent revascularization for limb salvage with cryopreserved saphenous vein allografts when autogenous saphenous vein was not available and prosthetic material was felt to be inappropriate. Their mean age was sixty-seven years. Risk factors included hypertension (88%), diabetes meltitus (63%), cigarette smoking (44%), and hypercholesterolemia (44%). All patients had multiple previous vascular operations including coronary artery bypass grafting (3.9 procedures per patient). Indications for operations were rest pain (8), ischemic necrosis (3), or both (6). All cryopreserved allografts were obtained from the same procurement source and prepared by a standardized protocol. Combinations of prosthetic material and cryopreserved allograft were used to make composite grafts (5 cases) when adequate length of autogenous saphenous vein was not available. Upper limb veins were not utilized. All patients received antiplatelet therapy or were anticoagulated postoperatively. Current follow-up is two to fifteen months. There were 1 death and 3 major amputations (including the 1 patient who died) in the postoperative period. Follow-up noninvasive vascular studies were obtainable in 13 patients whose limb was salvaged; 71% of assessable grafts were patent. Cryopreserved saphenous vein allografts provide a viable option for a selected group of patients when autogenous saphenous vein is not available.