Long-Term Evaluation of Human Umbilical Vein as Small-Caliber Arterial Substitute

Abstract

Since 1977, 61 arterial reconstruc tions using glutaraldehyde-tanned human umbilical vein (HUV) grafts were carried out in 56 patients (51 males, 5 females) with unsuitable au togenous saphenous vein. Their mean age was 69 ± 14 years. Limb salvage was the primary indication for sur gery. HUV grafts were used to perform 44 femoropopliteal, 4 composite aor topopliteal (with a direct end-to-end anastomosis between an aortofe moral Dacron graft and a femoropo pliteal HUV graft), 5 femorotibial, and 6 axillofemoral bypasses, and 1 femorofemoral and 1 iliopopliteal by pass. Ten-year cumulative patency rates were 31 % for all HUV recon structions, 36% for femoropopliteal bypasses, and 32% for femoropopli teal bypasses carried out for limb sal vage only. Four of the 5 femorotibial reconstructions failed during the first month following surgery. Two of the 6 axillofemoral and 3 of the 4 com posite aortopopliteal bypasses throm bosed within one and three years after surgery respectively. In conclu sion, the study evidenced long-term durability of HUV grafts, supporting their use for femorodistal reconstruc tions in patients with limb-threaten ing ischemia and inadequate autoge nous saphenous vein.