Result of Cold Stored Venous Graft for Popliteal Aneurysm

Abstract

Introduction - Popliteal aneurysm are the most common of peripheral aneurysm and accounting for at the least 70% of them. Autogenous great saphenous vein (GSV) remains the optimal conduit for popliteal aneurysm treatment. Therefor GSV is unavailable in up to 20% and sometimes present a great under sizing in comparison with the arteries in those patients. The aim of this study was to evaluate the safety and efficacy of the cold stored vein bypass in this indication. Methods - This is a retrospective analysis of 20 exclusions of popliteal aneurysm with cold stored venous allografts in a single institution between January 2007 to December 2017. Results - The mean age was 80,4 (+/-9,7) years , all patients were males. None had a suitable autogenous conduit for a vein by pass. Seventy percent of patients ( n=14) were treated for acute or critical limb ischemia. The distal anastomosis was performed to an infrapopliteal artery in 13 cases (65%). At 30 days, perioperative death rate was 10% (n = 2) and major adverse limb event was 20% (n=4). the mean follow-up was 34,15(+/-30.5) months ; at 1 year freedom for major adverse limb or perioperative death , survival , amputation free survival, primary and secondary patency rates were, respectively, 75%, 85%, 85%, 55% and 60% . Three patients had a major amputation with a permeable bypass. Acute ischemia was the most significant factor predicting failure of revascularisation. Conclusion - Cold stored allograft may be used for popliteal aneurysm treatment with safety and efficacy, this conduit may be usefully in emergency when its available. Their ease of use and avaibility are a major advantage compared with other biologic alternative sources.