Venous homografts in infra-inguinal procedures: an eight years experience

Autogenous saphenous vein is still the first choice graft material for femoro-distal bypass whenever it is available, but the choice of an alternative is still a challenging problem. Between 1982 and 1989, 100 femoro-distal reconstructions were performed with saphenous vein segment homografts, harvested during varicose vein stripping, they were selected, prepared and stored at 4 degrees C. In 71 cases the distal anastomosis was below the knee. According to the actuarial life table analysis (Kaplan & Meyer) the cumulative graft patency rate after 6 months, 1, 3, 5 and 7 years was 79%, 63%, 46%, 45% and 42% respectively. Twelve cases of aneurysm formation or stenosis requiring reintervention occurred. The patency rate was not influenced by the site of the distal anastomosis, but the condition of the run-off vessels had a significant influence on the early occlusion rate. Varicose vein segments are a readily available source of graft material. The low cost, easy storage and handling of these grafts justify their use in limb salvage procedures.