Two-year results of infrainguinal reconstructions using autovenous shunts and xenografts

Tishchenko I.S., Zolkin V.N., Maksimov N.V., Korotkov I.N., Demidov I.Yu., Barzaeva M.A

Department of Vascular Surgery, Municipal Clinical Hospital No 57, Moscow, Russia

The authors analysed two-year results of inftrainguinal distal arterial reconstructions using xenograft ("kemAngioprosthesis") as compared with an autovein.

Ours was a retrospective study including a total of 110 patients who endured 57 femoropopliteal (distal) and 54 femorotibial bypasses by means of both an autovein and a xenograft used as a shunt. The indications for reconstructive operation in the majority of cases was critical ischaemia induced by an atherosclerotic lesion of the femoropoplitealtibial segment corresponding to type D according to the TASC II classification. A xenograft was used only in case when the patient had neither great nor small saphenous vein suitable for use. Xenografts were used in 38 operations.

In femoropopliteal (distal) bypasses the primary two-year patency of the xenograft virtually did not differ from that of autovenous shunts (70.1 and 76.5%, respectively). The two-year limb salvage rate for xenografts and autoveins used as shunts amounted to 87.1 and 88.7%, respectively. In For femorotibial bypass grafting, primary 2-year patency of xenografts was considerably worse and amounted to 35.8 versus 73.7% for autovenous shunts. The two-year limb salvage rate did not depend upon the type of the shunt, amounting in both cases to 80.2%. A characteristic complication for using xenografts was aneurysmatic degeneration of the shunts, which was observed in 21% of cases averagely 2 years after surgery.

A conclusion was made that using xenografts for infrainguinal bypass operations may be considered as an adequate alternative in case of no autovenous material available.

KEY WORDS: xenograft, autovein, femoropopliteal bypass grafting, femorotibial bypass grafting, critical ischaemia, patency, limb salvage rate.

P. 135

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