Cryopreserved arterial homografts: preliminary results in infrageniculate arterial reconstructions

The aim of this report is to present our preliminary experience using cryopreserved arterial homografts in below-knee revascularization. We carried out a retrospective study at the Public Health Hospital of the Servicio Galego da Saude (SERGAS) from October 1995 to March 1997 in which cryopreserved arterial homografts were used for revascularization of 17 lower limbs in 16 patients. The clinical indications were limb-threatening ischemia in 15 lower extremities (7 with rest pain and 8 with ischemic ulcers or gangrene), and large aneurysms of femoropopliteal arteries in 2. In addition, 75% of the patients had undergone previous surgical procedures for revascularization on the involved extremity. No patient had a suitable greater saphenous vein in the ipsilateral extremity and all patients required a below-knee arterial reconstruction procedure. There was just one runoff vessel in 11 of 17 extremities (65%). A histological exam was performed in four patients who died (1 case) or had homograft-related complications (3 cases). The results of this study indicated that cryopreserved arterial homografts could be a promising alternative when below-knee revascularization is required in patients lacking suitable greater saphenous vein, especially in those with limited life expectancy, but despite early acceptable results, many aspects must be clarified. Close follow-up is mandatory.