Extended study of aneurysm formation in umbilical vein grafts

Biological grafts as arterial substitute in the infragenicular level: A prospective evaluation

“…Dardik et al reported a 30% incidence of aneurysm at five years with first-generation grafts, but only 6% required surgery [8]. Late aneurysm formation was not observed in this study, but very few patients survived with a bypass longer than five years [1,15]. In our study, 2 anastomotic aneurysms, which both seemed to have been caused by excessive trauma to grafts, were observed and corrected.…”

A decade of experience with the glutaraldehyde-tanned human umbilical cord vein graft for revascularization of the lower limb

“…Hasson et ala8 have properly emphasized the potential for all umbilical vein grafts to undergo mural degeneration with time but have failed to distinguish this problem from their ability to maintain patency and thereby effect limb salvage for reasonable periods of time in carefully selected patients. In a study by Karkow et al,19 duplex scanning showed that umbilical vein grafts became aneurysmal in 8 of 24 grafts (33%) patent at 3 years, 9 of 20 (45%) patent at 4 years, and in 13 of 20 (65%) patent at 5 or more years. Their greater number of aneurysms reflects the inclusion of dilatation in the defmition of aneurysmal formation.…”

Femoropopliteal prosthetic bypass with glutaraldehyde stabilized human umbilical vein (HUV)

“…38 Karkow and other investigators explained aneurysmal degeneration in first generation HUV besides local destruction of the graft wall itself with the loosely knitted and weak external Dacron mesh and even found local mesh destruction. 39,40 Sommeling, investigating the original HUV grafts with duplex scan, reported a rate of 37% aneurysmal degeneration with a mean diameter of 12.6 mm but a need of graft removal only in two cases with large aneurysms and recommended a reluctant policy of further thorough duplex surveillance. 41 Aalders found aneurysmal changes in 30% of patent HUV grafts after a mean follow-up of 78 months necessitating surgical intervention in one case.…”