Umbilical vein grafts for reconstructive surgery below the inguinal ligament

Thirty-five of 118 bypass procedures of the lower extremities were performed using umbilical vein grafts (Biograft) in patients without suitable great saphenous veins. Four early thromboses occurred, and two thrombectomies were performed, one successfully. Two late thromboses occurred, and in both cases thrombectomies were attempted, one successfully. Four grafts (11 per cent) occluded within a mean follow-up time of 10 months. The accumulated patency was 80 per cent after 21 months. Three patients with thrombosed grafts received below-the-knee amputations. One patient with an open graft also received a below-the-knee amputation because of osteomyelitis and muscle necrosis. Finally, one patient with an open graft underwent an amputation of the forefoot because of small vessel disease.