Cryopreserved Allografts for Treatment of Chronic Limb-Threatening Ischemia in Patients Without Autologous Saphenous Veins

Guevara-Noriega, Kerbi Alejandro; Lucar-Lopez, Gustavo; Pomar, José L.

doi:10.1016/j.avsg.2019.03.018

Cited by 14 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are hardly any reports that compare the results of venous and arterial allografts. The vast majority of publications report the results of venous allografts [ 17 – 21 ], with fewer studies presenting the results of arterial allograft implantations [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of arterial and venous allograft bypass in chronic limb-threatening ischemia

Garcı́a-Dorado

Osztrogonacz²,

Boros³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Introduction Femoro-popliteal bypass with autologous vascular graft is a key revascularization method in chronic limb-threatening ischemia (CLTI). However, the lack of suitable autologous conduit may occur in 15–45% of the patients, necessitating the implantation of prosthetic or allogen grafts. Only little data is available on the outcome of allograft use in CLTI. Aims Our objective were to evaluate the long term results of infrainguinal allograft bypass surgery in patients with chronic limb-threatening ischemia (CLTI) and compare the results of arterial and venous allografts. Methods Single center, retrospective study analysing the outcomes of infrainguinal allograft bypass surgery in patients with CLTI between January 2007 and December 2017. Results During a 11-year period, 134 infrainguinal allograft bypasses were performed for CLTI [91 males (67.9%)]. Great saphenous vein (GSV) was implanted in 100 cases, superficial femoral artery (SFA) was implanted in 34 cases. Early postoperative complications appeared in 16.4% of cases and perioperative mortality (<30 days) was 1.4%. Primary patency at one, three and five years was 59%, 44% and 41%, respectively, while secondary patency was 60%, 45% and 41%, respectively. Primary patency of the SFA allografts was significantly higher than GSV allografts (1 year: SFA: 84% vs. GSV: 51% p = 0,001; 3 years: SFA: 76% vs. GSV: 32% p = 0,001; 5 years: SFA: 71% vs. GSV: 30% p = 0.001). Both primary and secondary patency of SFA allograft implanted in below-knee position were significantly higher than GSV bypasses (p = 0.0006; p = 0.0005, respectively). Limb salvage at one, three and five years following surgery was 74%, 64% and 62%, respectively. Long-term survival was 53% at 5 years. Conclusion Allograft implantation is a suitable method for limb salvage in CLTI. The patency of arterial allograft is better than venous allograft patency, especially in below-knee position during infrainguinal allograft bypass surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of arterial and venous allograft bypass in chronic limb-threatening ischemia

Garcı́a-Dorado

Osztrogonacz²,

Boros³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Dead cause and future analysis should be researched in future publications. Our team has previously focus in this specific endpoint 21,22 . A direct comparison between grafts is considered incorrect because of several factors affecting the outcomes.…”

Section: Discussionmentioning

confidence: 99%

Resultados de los transplantes de aloinjertos vasculares en la comunidad autonoma de Cataluña, España

Guevara-Noriega¹,

Villamizar²,

Castro-Rios³

et al. 2021

CIRU

View full text Add to dashboard Cite

Background:The transplantation of tissues is a developing practice. Improving cryopreservation techniques and emerging of new immunobiology concepts have let to establish the transplant of vascular allografts as a suitable alternative. This study aims to expose the Catalan experience in vascular allograft transplantation by disclosing basic data about clinical outcomes. Materials and Methods: Data about vascular allografts transplants was gathered from the Registry of Vascular and ValvularTransplantation of Catalonia, Spain. Basic data regards to clinical outcomes are presented. Kaplan-Meier and statistical analysis were performed using SPSS Ver. 20 for Mac (Chicago USA). Results: One hundred and seventy-one adults were transplanted. The overall 5-year SR was 51.5%. Survival (SR) differs with the territory revascularized, ranging from 37.5% to 55.6% at five years. Major adverse limb event-free rate ranges from 13.3% to 50.1% according to the area treated. The Primary patency rate is higher in the supra-inguinal revascularization and lowers when a distal vessel target is treated. Conclusion: Only one guideline-supported indication is currently done for allografts, and our results match with this indication. Our results are extensive and susceptible to analysis to address future projects, which are required to reconsider new or specific indications. More studies are needed to clarify the outcomes of arterial allografts.

show abstract

“…In addition, the occurrence of early occlusion (within 30 days) of the allografts varies in a broad range between 0-17% [3][4][5][6][7][8][9][10][11], which could be traced back to effects of multiple factors, such as anatomical location or quality of the allograft. The patency of the implanted grafts strongly depends on the preservation of the inherent thromboresistance of the native arterial wall, i.e.…”

Section: Introductionmentioning

confidence: 99%

Cryopreservation moderates the thrombogenicity of arterial allografts during storage

et al. 2021

View full text Add to dashboard Cite

Introduction Management of vascular infections represents a major challenge in vascular surgery. The use of cryopreserved vascular allografts could be a feasible therapeutic option, but the optimal conditions for their production and use are not precisely defined. Aims To evaluate the effects of cryopreservation and the duration of storage on the thrombogenicity of femoral artery allografts. Methods In our prospective study, eleven multi-organ-donation-harvested human femoral arteries were examined at five time points during storage at -80°C: before cryopreservation as a fresh native sample and immediately, one, twelve and twenty-four weeks after the cryopreservation. Cross-sections of allografts were perfused with heparin-anticoagulated blood at shear-rates relevant to medium-sized arteries. The deposited platelets and fibrin were immunostained. The thrombogenicity of the intima, media and adventitia layers of the artery grafts was assessed quantitatively from the relative area covered by fibrin- and platelet-related fluorescent signal in the confocal micrographs. Results Regression analysis of the fibrin and platelet coverage in the course of the 24-week storage excluded the possibility for increase in the graft thrombogenicity in the course of time and supported the hypothesis for a descending trend in fibrin generation and platelet deposition on the arterial wall. The fibrin deposition in the cryopreserved samples did not exceed the level detected in any of the three layers of the native graft. However, an early (up to week 12) shift above the native sample level was observed in the platelet adhesion to the media. Conclusions The hemostatic potential of cryopreserved arterial allografts was retained, whereas their thrombogenic potential declined during the 6-month storage. The only transient prothrombotic change was observed in the media layer, where the platelet deposition exceeded that of the fresh native grafts in the initial twelve weeks after cryopreservation, suggesting a potential clinical benefit from antiplatelet therapy in this time-window.

show abstract

Cryopreserved Allografts for Treatment of Chronic Limb-Threatening Ischemia in Patients Without Autologous Saphenous Veins

Cited by 14 publications

References 20 publications

Comparison of arterial and venous allograft bypass in chronic limb-threatening ischemia

Comparison of arterial and venous allograft bypass in chronic limb-threatening ischemia

Resultados de los transplantes de aloinjertos vasculares en la comunidad autonoma de Cataluña, España

Cryopreservation moderates the thrombogenicity of arterial allografts during storage

Contact Info

Product

Resources

About