Mural degeneration in the glutaraldehydetanned umbilical vein graft: Incidence and implications

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

“…Besides local wall dissection and intramural formation of hematoma, he described giant cell reaction in the diseased graft segments. 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.…”

Outcomes of complex femorodistal sequential autologous vein and biologic prosthesis composite bypass grafts

“…Historically, the rate of biodegeneration for the HUV was as high as 57% after 2 years. 31,32 The incidence of graft aneurysms decreased significantly for the more recent implants. 33 Our series of second-generation HUVs in the popliteal position identified a late aneurysm rate of 7% for grafts with a low intervention rate of 3.5%.…”

Strategies for Hemodialysis Access: Where to Start, Where to Go Next

“…Bovine grafts are not utilized because of the tendency toward aneurysm formation.17 Human umbilical vein, treated with glutaraldehyde and reinforced with a Dacron mesh,18 has also tended to form pseudoaneurysms, and interest in this conduit for dialysis access has waned. 19 Cryopreserved femoral vein allografts (CryoVein,® CryoLife, Kennesaw, Georgia) have been used successfully in patients with previous infection or multiple graft failures,20 but a recent report describes complications of graft infection and rupture, particularly when placed in the thigh position.21 Since the early reports three decades ago of the use of expanded polytetrafluoroethylene (PTFE) for AV access,22,23 these grafts have become the most frequently used prosthetic conduit for hemodialysis. This remains true despite suboptimal long-term patency rates when PTFE grafts are used for AV access.24,25 Modifications in existing grafts or development of new graft materials have been attempted to improve primary and secondary patency rates and reduce complications.…”