Reoperation for complications of stabilized human umbilical vein grafts

Abstract

Among 211 femoropopliteal bypass grafts constructed with stabilized human umbilical vein performed between 1977 and 1986, 3 major complications were seen: graft thrombosis, aneurysm formation, and infection. Early thrombosis (within 30 days of operation) was successfully treated in 14 of 17 patients (82 percent) with either graft thrombectomy (13 of 17 patients) or graft replacement (1 patient). Late graft closure (2 to 55 months after operation) was successfully treated with thrombectomy in 17 of 28 patients (61 percent) or graft revision or replacement in 4 patients (14 percent). Aneurysms and graft infections were each seen in 3 percent of the grafts at risk. The former were successfully reconstructed in six of seven instances, whereas the latter eventuated in amputation in six of seven patients. An aggressive approach to graft closure in stabilized human umbilical vein grafts is recommended as this conduit is amenable to thrombectomy or revision if closure occurs.