Long-term function of NCGT vascular conduits in a multicenter trial: evaluation of physical chemical parameters

Cryopreserved arterial allografts for limb salvage in the absence of suitable saphenous vein: two-year results in 20 cases

From January 1992 to November 1992, 20 cryopreserved arterial allografts were used as below-knee bypasses for repeated limb salvage in 18 patients lacking saphenous vein grafts. Arteries were obtained during multiorgan harvesting. A scheduled program of cryopreservation with 15% dimethylsulfoxide was used. Mean storage period was 37 days. All cases were matched for blood group compatibility. Patency was checked at 10 and 90 days and twice a year thereafter. Conventional arteriography was routinely performed 3 months postoperatively. Average follow-up was 26.8 months for the 18 patients and 20.8 months for the 20 bypass grafts. No patients were lost to follow-up. Aneurysmal dilation developed in one graft, which was replaced by another homograft. During follow-up 10 grafts occluded: five once, four twice, and one four times. These 10 grafts underwent a total of 16 reinterventions. Thrombectomy with angioplasty was performed 15 times and graft replacement once because of proximal and distal arterial deterioration. Primary actuarial patency was 68% at 1 year and 42% at 2 years. Secondary actuarial patency was 89% at 1 year and 72% at 2 years. Preliminary results of cryopreserved arterial allografts for repeated limb salvage in the absence of available saphenous veins are encouraging. Further studies are needed to determine the long-term deterioration rate of cryopreserved arterial allografts.

Ten year experience with the negatively charged glutaraldehyde-tanned vascular graft in peripheral vascular surgery. Initial multicenter trial

The negatively charged glutaraldehyde-tanned vascular graft was developed to determine the utility of grafts of biologic origin to provide satisfactory revascularization for ischemic limbs with advanced arteriosclerotic peripheral vascular disease. The bovine carotid artery was modified under a number of conditions using a large number of variables and evaluated in the carotid artery and aorta of dogs. Eventually ficin-digested carboxylated glutaraldehyde-tanned grafts were selected as being most antithrombotic and most resistant to aneurysm formation. Under an Investigational Device Exemption with the Food and Drug Administration, 146 grafts were evaluated in 108 patients with patency approaching 67 percent for all grafts at 5 years and 59 percent at 9 years plus. Total aneurysm formation has been 4 percent (six grafts) occurring only in hypertensive patients. The graft is now undergoing clinical use and evaluation worldwide.