Matches in UGent Biblio for { ?s ?p Objective: The lack of a suitable alternative for autologous vein grafts is usually the limiting factors for complex vascular reconstructions in critical limb ischemia (CLI). Prosthetic grafts, even with adjuncts have a dismal prognosis at this level. Based on previous experimental work we reviewed our experience with cryopreserved vein allografts as an alternative conduit for infrapopliteal reconstructions. Methods: Between 1991 and 2005, 108 cryopreserved saphenous allografts were implanted on crural or pedal arteries in 92 patients with CLI. These patients were prospectively followed until march 2007 for graft patency, limb salvage and patient survival. There were 42 woman and 50 men with a mean age of 71 years (range 39–88 years). Atherosclerosis was the main cause of CLI (57%) followed by diabetes (41%). Most patients had a previous vascular reconstruction in the same leg. All allografts were matched for ABO-compatibility and recipients received low dose immunosuppression for one year. Results: The primary and secondary patency rates were 56% and 73% at one year, 32% and 60% at three years, and 17% and 38.5% at five years. The limb-salvage rate was 84.9% at one year and 63.7% at five years. The patient survival was 87.4% at one year and 64.5% at five years. No predictive risk factors were correlated with graft patency or patient survival. Conclusions: Cryopreserved greater saphenous vein allografts with low-dose immunosuppression have better patency rates than prosthetic grafts in femoro-crural reconstructions and have the advantage of being resistant to infection. Graft and patient selection, optimalization of compatibility and immunosuppression can improve the results. They are a valuable alternative conduit when autologous veins are not available.. }
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- aggregation abstract "Objective: The lack of a suitable alternative for autologous vein grafts is usually the limiting factors for complex vascular reconstructions in critical limb ischemia (CLI). Prosthetic grafts, even with adjuncts have a dismal prognosis at this level. Based on previous experimental work we reviewed our experience with cryopreserved vein allografts as an alternative conduit for infrapopliteal reconstructions. Methods: Between 1991 and 2005, 108 cryopreserved saphenous allografts were implanted on crural or pedal arteries in 92 patients with CLI. These patients were prospectively followed until march 2007 for graft patency, limb salvage and patient survival. There were 42 woman and 50 men with a mean age of 71 years (range 39–88 years). Atherosclerosis was the main cause of CLI (57%) followed by diabetes (41%). Most patients had a previous vascular reconstruction in the same leg. All allografts were matched for ABO-compatibility and recipients received low dose immunosuppression for one year. Results: The primary and secondary patency rates were 56% and 73% at one year, 32% and 60% at three years, and 17% and 38.5% at five years. The limb-salvage rate was 84.9% at one year and 63.7% at five years. The patient survival was 87.4% at one year and 64.5% at five years. No predictive risk factors were correlated with graft patency or patient survival. Conclusions: Cryopreserved greater saphenous vein allografts with low-dose immunosuppression have better patency rates than prosthetic grafts in femoro-crural reconstructions and have the advantage of being resistant to infection. Graft and patient selection, optimalization of compatibility and immunosuppression can improve the results. They are a valuable alternative conduit when autologous veins are not available.".