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Updated: Jul 15, 2026
Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement
Published on: October 1, 2014
Homologous veins as an arterial substitute: long-term results
Insights
Homologous vein grafts show variable patency, with 50% occlusion by 1 year but sustained function in 60% for over 5 years. Despite requiring revisions, they are a viable option when autogenous tissue is unavailable.
Area of Science:
- Vascular Surgery
- Biomaterials Science
- Immunology
Background:
- Homologous vein grafts have been utilized in various vascular reconstructions.
- Previous operations were common in patients receiving these grafts, often for limb salvage.
Purpose of the Study:
- To evaluate the long-term patency and outcomes of homologous vein grafts in diverse arterial positions.
- To assess the suitability of homologous saphenous veins as substitutes for autogenous tissue.
Main Methods:
- Retrospective analysis of 129 homologous vein grafts implanted between 1968 and 1982.
- Life-table method used to calculate cumulative patency rates.
- Grafts analyzed in femoropopliteal, aortocoronary, and aortopulmonary positions, among others.
Main Results:
- Lower extremity graft patency ranged from 0 to 121 months (mean 22.4 months).
- 50% of grafts occluded by 1 year; however, 60% of remaining grafts remained functional for over 5 years.
- Aortocoronary bypass grafts had 50% occlusion at 1 year. Eight of 13 pulmonary artery shunts remained patent.
Conclusions:
- Homologous vein grafts require frequent revisions and thrombectomies to maintain patency.
- Graft outcome is unpredictable, largely due to graft antigenicity.
- Homologous saphenous veins can be a suitable substitute when autogenous tissue is unavailable, provided significant effort is invested in maintaining patency.
Abstract:
From 1968 through 1982, 129 homologous vein grafts were used in 91 patients in the following positions: 75 in the femoropopliteal, tibial, or peroneal artery; 38 in the aortocoronary artery; 13 in the aortopulmonary artery; and one each in the atrioventricular fistula, carotid-subclavian artery, and brachial-radial artery. In the lower extremity patency ranged from 0 to 121 months (mean 22.4 +/- 4.4 months). All grafts were performed for limb salvage, and 75% of the patients had undergone previous operations. Cumulative patency by the life-table method showed that while 50% of grafts occluded by 1 year, 60% of the remaining grafts continued to be functional for more than 5 years. Fifty percent of the aortocoronary bypass grafts studied were occluded at 1 year. Eight of the 13 systemic pulmonary artery shunts were patent at time of death, revision, or total correction. Multiple revisions and thrombectomies are required to maintain patency of homograft veins. The outcome is variable and unpredictable. The inconsistency is due to the antigenicity of the graft. If one is committed to the necessary efforts required to ensure long-term patency, the homologous saphenous vein is a suitable substitute when autogenous tissue is unavailable.
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