Biogenic grafts in arterial surgery--long-term results (I. The homologous vein--II. The modified heterologous bovine carotid artery--III. The human umbilical vein).

Abstract

This report summarizes the authors' experience with homologous vein grafts, modified heterologous bovine carotid artery grafts and human umbilical vein grafts in reconstructive vascular surgery. The homologous saphenous vein, taken from living donors, was implanted in 21 patients. The high percentage of early and late complications (28% and 38%, respectively), the difficult availability and the development of modern materials appear to suggest that these grafts, at least the type used in this study, should no longer be employed. The experience with 102 femoro-popliteal and femoro-tibial bypasses in 140 revascularization operations carried out with modified heterologous bovine carotid artery grafts (Solcograft) is presented. The cumulative patency rate was 43% after 5 years for the above-knee and 33% for the below-knee femoro-popliteal bypasses. The high early and late complication rates (37% and 35%) lead us to believe that this graft should also no longer be employed. The human umbilical cord vein (Meadox-Dardik-Biograft) was used in performing 68 femoro-popliteal and 15 femoro-crural bypasses in 60 limbs of 57 patients. The patency rates calculated according to the standard life table method was 36% for the above-knee (after 5 years) and 32% for the below-knee femoro-popliteal bypass (after 4 years) and 31% (after 3 years) for the femoro-tibial bypass, respectively. On the understanding that other materials should be preferred in the individual case, this material still seems to be recommendable as a graft of second or third choice.