The Biograft for femoropopliteal bypass.

A consecutive unselected series of 189 femoropopliteal bypass procedures with a modified human umbilical cord vein, the Biograft, is analysed. The distal anastomosis was above the knee in 62% and below the knee in 38% of the cases. No patient was lost to follow-up. The cumulative patency rate, according to the life-table method, is 86.4% after 1 year and 70.9% after 4 years. Data related to the location of the distal anastomosis and the patency rate are considered. Obstruction of the outflow tract, due to progressive atherosclerotic disease, was the most important cause of a failure, accounting for almost two-thirds of the cases. Biograft-related causes of failure were mainly thrombosis due to kinking in four cases with a below-knee anastomosis. Anastomotic obstruction occurred seven times. The Biograft seems to be a good arterial substitute for femoropopliteal bypass operations above and below the knee.