Denatured venous homograft as an arterial substitute in civilian vascular injuries. Thirty months' experience.

OBJECTIVES

Autologous saphenous vein (ASV) for arterial reconstruction, in vascular limb injuries is the graft material of choice. Denatured saphenous vein homograft (DSVH), thanks to its characteristics of readily available autologous biological prosthesis, has been proposed as alternative. We report our prospective experience with DSVH employed for arterial reconstruction in civilian limb vascular injuries.

MATERIALS: From January 1994 to June 1996, DSVH was implanted in 16 male patients (pts.) treated for arterial civilian injuries of eight upper limbs and eight lower limbs.

METHODS

In 14 cases it was performed as an interposition graft and in two cases a bypass. We performed a 30-month follow-up and a 20-month mean follow-up.

RESULTS

Four patients had graft thrombosis at the first postoperative week and were submitted to the replacement of the graft with reappearance of distal arterial pulse; one of them had graft failure at the fifth postoperative week and because the necrosis due to extensive soft tissue damage, he was submitted to limb amputation. After 30-months' follow-up we obtained 75% primary patency rate and 93% secondary patency rate.

CONCLUSIONS

In the absence of suitable ASV, DSVH appears to be an interesting alternative for arterial repair in limbs in civilian vascular injuries.