Related Experiment Video
Updated: Dec 19, 2025
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Single Tertiary Care Center Outcomes After Lower Extremity Cadaveric Vein Bypass for Limb Salvage
Kuldeep Singh1, Amandeep Juneja1, Tushar Bajaj1,2
1Staten Island University Hospital, Staten Island, NY, USA.
Insights
Cadaveric saphenous vein (CV) allografts offer a viable limb salvage option when autogenous veins are unavailable. Despite lower patency rates, CV bypasses achieved significant limb salvage in patients with critical limb ischemia.
Area of Science:
- Vascular Surgery
- Regenerative Medicine
- Biomaterials Science
Background:
- Cadaveric saphenous vein (CV) grafts are infrequently used for limb salvage due to limited outcome data.
- Patients without autogenous veins pose a challenge for revascularization procedures.
Purpose of the Study:
- To evaluate the long-term outcomes of CV bypass in patients experiencing threatened limbs.
- To assess graft patency, amputation rates, and survival following CV allograft use.
Main Methods:
- Retrospective review of 30 CV lower extremity bypasses in 25 patients (2010-2017).
- Analysis of demographics, comorbidities, and surgical outcomes including primary and secondary patency, amputation, infection, and mortality.
- Kaplan-Meier survival curves and time series analysis were employed.
Main Results:
- 12-month primary patency was 28%, with assisted primary patency at 37%.
- Minor amputation rate was 20%, and wound infection occurred in 32% of patients.
- 12-month amputation-free survival was 68%, and overall survival was 84%.
Conclusions:
- Cadaveric saphenous vein allografts represent a viable surgical option for limb salvage when autogenous vein is not available.
- While patency rates are suboptimal, CV grafts demonstrate potential for limb salvage in select cases.
Objective:
Cadaveric saphenous vein (CV) conduits are used in rare instances for limb salvage in patients without autogenous veins although long-term outcome data are scarce. This study was designed to evaluate the outcomes of CV bypass in patients with threatened limbs.
Methods:
We retrospectively reviewed the charts from 2010 to 2017 of 25 patients who underwent 30 CV allografts for critical limb ischemia and acute limb ischemia. Patient charts were reviewed for demographics, comorbidities, smoking status, indications for bypass, and outcomes. Primary outcomes included graft patency, major amputation rates, and mortality. Secondary outcomes measured included infection rates, 30-day major adverse cardiac events (MACE) and major adverse limb events (MALE). Statistical analysis was performed using time series and Kaplan-Meier survival curves.
Results:
A total of 30 limbs received CV lower extremity bypasses (20 males, 10 female), and the average age was 68 ± 4 years. Primary patency rates were 71%, 42%, and 28% at 3, 6, and 12 months, respectively. Assisted primary patency rates were 78%, 56%, and 37% at 3, 6, and 12 months, respectively. Secondary patency rates were 77%, 59%, and 28% at 3, 6, and 12 months, respectively. Minor amputations, defined as amputations below the transmetatarsal level occurred in 5 (20%) patients. Wound infection occurred in 8 (32%) patients which was managed with local wound care and no patients required an extraanatomic bypass for limb salvage. Thirty-day MALE occurred in 7 (23.3%) patients. We had no 30-day mortality or MACE. The average graft length was 64.2 ± 8 cm with an average graft diameter of 3.9 ± 2 mm. Amputation-free survival and overall survival at 12 months were 20 (68%) and 21 (84%), respectively.
Conclusions:
Cadaveric saphenous vein allograft may be used as a bypass conduit as a viable surgical option before limb amputation. Despite the poor patency rates, the limb salvage rates of cadaveric vein grafts demonstrate that this alternate conduit may be considered when no autogenous vein is available.
More Related Videos
08:05Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
07:02A Rabbit Venous Interposition Model Mimicking Revascularization Surgery using Vein Grafts to Assess Intimal Hyperplasia under Arterial Blood Pressure
Published on: May 15, 2020
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:15Veins of Lower Limbs
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the...
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
01:27Peripheral Artery Disease III: Interprofessional Care
01:17Veins of Upper Limbs
The deep venous system is primarily composed of the ulnar and radial veins. The ulnar vein, which drains the fingers through the superficial palmar venous arches, and the radial vein, which serves the palms via the deep palmar...
01:25Hemodialysis I: Introduction