C. DeHaven1, E. Lavanga1, L. Dogbe1, K. Krause1, A. Zil-E-Ali2, F. Aziz2 1Penn State University College Of Medicine, Hershey, PA, USA 2Penn State Hershey Medical Center, Division Of Vascular Surgery, York, PA, USA
Introduction
Cryopreserved superficial femoral artery (SFA) is an available alternative for patients lacking suitable or available autologous veins for bypass. Cryopreserved great saphenous vein has been used as a conduit with variable success, but cryopreserved SFA is a relatively less explored option. This study aims to compare the postoperative outcomes and patency of cryopreserved SFA to autologous great saphenous vein (GSV) as conduits for infrainguinal revascularization.
Methods:
Between April 2003 and May 2022, 83 patients underwent infrainguinal bypass, 54 patients using great saphenous vein, and 29 patients using cryopreserved SFA. Demographic data and patient outcomes were retrospectively collected using the electronic medical record. Patients with missing data, or who were lost to follow up were excluded.
Results
Patients undergoing revascularization with Cryo SFA presented older than their counterparts using GSV, 68 vs. 62, respectively. They were significantly more likely to present with a partially or wholly dependent functional status (p=0.042). Cryo SFA patients had significantly higher rates of hypertension, diabetes, congestive heart failure, and peripheral arterial disease. Among our primary and secondary outcomes, the Cryo SFA cohort had higher rates of 30-day amputation (17.2% vs. 6.82%) and unplanned return to the OR (24.1% vs. 14.8%). The GSV conduit group had higher mortality rates (23.2% vs. 13.8%) and 30-day readmission (10.8% vs. 6.9%). 30-day and primary patency were higher in the GSV group at 96.3% (Cryo SFA 89.3%). At 1-year, primary patency was 74.7% in the GSV group and 67.9% in the Cryo SFA group. Although, no significant differences were found in any of the primary or secondary outcomes.
Conclusion
Our results highlight that cryopreserved SFAs have reasonable patency rates when compared with the first-line conduit, autologous GSV. While autologous saphenous vein maintains its superiority in primary patency and amputation, these differences are not statistically different. This retrospective analysis suggests that Cryo SFA is an acceptable option with comparable patency and limb salvage to GSV in patients lacking suitable autologous veins.