VS07 EXCELLENT LATE OUTCOME WITH DENATURATED HUMAN UMBILICAL VEIN (HUV) IN FEMOROPOPLITEAL BYPASS SURGERY – A GOOD EXAMPLE FOR THE IMPORTANCE OF BIOLOGICAL MATERIALS IN VASCULAR SURGERY

Abstract

Purpose: Femoropopliteal bypass with autologous vein provides excellent long term results in lower limb bypass. In case of unsuitable vein generally synthetic PTFE prostheses are preferred. Denaturated human umbilical vein was used as femoropopliteal bypass graft when autologous vein was not available. Long term results of a consecutive single center series are presented.Methodology: HUV was implanted in femoropopliteal position in case of unavailable vein for symptomatic peripheral vascular disease or popliteal aneurysm. Follow‐up examinations were performed after 3, 6, 12, 18, 24 months and annually thereafter. Duplex scan was used for detection of potential biodegeneration of the HUV.Results: From 01/94 to 01/05 in 197 patients (119 male, 78 female; age 70 ± 8.7 years) 211 femoropopliteal bypasses were constructed with HUV (65 above knee and 146 below knee) for critical ischemia or severe disabling claudication. In 16% thrombotic occlusion prompted early postoperative revision to restore patency. After a mean follow up of 44 months primary, primary assisted and secondary 5 year patency were 54%, 63% und 76% with a limb salvage rate of 92%. In grafts patent for more than 36 months aneurysmal degeneration was found in 6 cases (7%).Conclusion: Despite a considerable rate of early thrombotic occlusions femoropopliteal HUV bypass exhibits an excellent long term function with a tolerable rate of aneurysmal graft degeneration. Biological prosthetic small calibre grafts should be considered as a valuable alternative to the preferentially used synthetic PTFE grafts.