Our eight-year experience with human umbilical vein grafts

From 1977 through 1984, 58 arterial reconstructions using glutaraldehyde-tanned human umbilical vein (H.U.V.) grafts were carried out: 41 femoropopliteal, 4 composite aortopopliteal (a Dacron graft was inserted proximally), 5 femorotibial, 6 axillofemoral, 1 femorofemoral, and 1 iliofemoral bypass. Autogenous saphenous vein was absent or inadequate in all patients. Limb salvage was the primary indication for surgery (89.7%). Five and 8 years cumulative patency rates were 42.8% and 35.1% respectively for all H.U.V. by-passes and 52.4% and 41.9% respectively for femoropopliteal by-passes. Four out of the 5 femorotibial by-passes failed during the first month following surgery. Two of the 6 axillofemoral and 3 of the 4 composite aortopopliteal by-passes thrombosed within 1 and 3 years after surgery, respectively. Perioperative mortality was 5.1%, while overall mortality was 17.2%. The following conclusions can be drawn from these results: H.U.V. grafts did not achieve cumulative patency rates superior to those reported with autogenous saphenous vein, in limb salvage situations, when the saphenous vein is not available, the H.U.V. graft offers acceptable salvage rates, results from the 8-year follow-up period demonstrate the durability and long-term patency of H.U.V. grafts.