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Venous allografts for critical limb ischaemia
H Van Damme1, E Creemers, R Limet
1University Hospital of Liège, Department of Cardiovascular Surgery, Belgium.
Acta Chirurgica Belgica
|January 1, 1995
Summary
Preserved venous allografts offer an alternative for critical limb ischemia when autogenous veins are unavailable. While facing challenges, these grafts achieved a 67% limb salvage rate in this study.
Area of Science:
- Vascular Surgery
- Regenerative Medicine
- Biomaterials Science
Background:
- Critical lower limb ischemia often lacks suitable autogenous vein grafts.
- Prosthetic grafts show poor patency below the knee.
- Venous allografts are being re-evaluated for limb salvage.
Purpose of the Study:
- To assess the efficacy of preserved venous allografts in revascularizing ischemic limbs.
- To evaluate graft patency and limb salvage rates.
- To compare outcomes with existing literature on venous allografts.
Main Methods:
- 12 ischemic limbs were revascularized using preserved venous allografts (10 at 4°C, 2 Varivas).
- Indications included rest pain and tissue necrosis; most patients had prior revascularizations.
- Distal anastomoses were performed below the knee, often at the tibial level.
Main Results:
- One Varivas graft ruptured, leading to amputation; others remained patent for a mean of 10.6 months.
- Six grafts are currently patent; the limb salvage rate was 67% (8/12) at a mean 13-month follow-up.
- One-year patency is approximately 50%, with grafts progressing to fibrous conduits.
Conclusions:
- Preserved venous allografts can be a viable option for limb salvage in critical ischemia when autogenous options are absent.
- Despite limitations, including potential for fibrous degeneration, venous allografts demonstrate a significant limb salvage rate.
- Further research is needed to optimize venous allograft use and long-term patency in arterial reconstruction.