Cryopreserved saphenous vein allograft for infragenicular bypass in the presence of foot infection

Abstract

We report our distal bypass experience with cryopreserved saphenous vein allograft (CSVA) in 12 patients presenting with infection and no autologous saphenous vein available. Twelve patients underwent 13 arterial reconstructions. The mean age of the cohort was 68.4 years. Ninety-two percent (92%) of the patients presented with Rutherford Class 5 or 6 disease which required wide debridement and copious irrigation of all infected tissue beds. All distal anastomoses were to infragenicular vessels. Two patients died with patent grafts during follow-up for an 83% survival rate. Three grafts failed during follow-up between one and 36.3 months, of which two underwent amputation for an 82% limb salvage rate. The primary and primary assisted patency rate was 40% and 60% at 18 months follow-up, respectively, and no recurrent infections. In patients who have complex risk factors and the presence of infection, CSVA appears to be a reasonable option for limb salvage.

Necrotizing Soft Tissue Infection Following a Peripheral Bypass

“…In a small study of 12 patients where CryoVein was used for infragenicular bypass in the setting of infection, no postoperative infections occurred. 9 NSTI has not been a reported complication of peripheral bypass surgery. It has, however, occurred following other operations, documented in scattered case reports.…”