Abstracts

Introduction: Late results for autologous vein bypass regarding graft patency and limb salvage in lower limb ischemia are excellent.In case of inadequate autologous vein besides synthetical graft material use of a biological vascular conduit may be considered.Currently only the glutaraldehyde tanned ovine collagen prosthesis (Omniflow II) is available.Three years experience of a consecutive series with this biosynthetical prosthesis are presented.Material and methods: In case of insufficient autologous vein for a complete autologous vein bypass in acute or chronic lower extermity ischemia with possible popliteal anatomosis the ovine collagen prosthesis was chosen.Follow up was initiated after 3, 6, 12, 18, 24 months and yearly thereafter Results: From 06/10 to 05/13 in 48 patients (28 men and 20 women; 69+-10, 52-93 years) 48 popliteal bypass operations were performed in 48 legs for acute or chronic ischemia, femoropopliteal aneurysm or bypassgraft degeneration.26 operations were necessary for chronic critical ischemia or acute ischemia.In 22 cases disabling claudication, a degenerated biological graft or a femoropopliteal aneurysm was the underlying indication.17 grafts were anastomosed to the above knee popliteal artery.In 12 cases the implant was used for reoperation after previously failed reconstruction.Two patients (4.1%) with chronic critical ischemia (one patient hemodialysis dependent) died within 30 days postoperatively from septic complications with multiorgan failure.In one of these patients early major amputation was necessary.In four patients early graft thrombosis was responsible for surgical graft revision.In a patient with deep wound infection partial graft replacement with later complete redo bypass was necessary.After a mean follow up of 11 months (1-26 months) one bypass occlusion was treated with successful thrombectomy.Early results in regards of bypass patency and limb salvage are presented Discussion: The use of the ovine collagen prosthesis in femoropopliteal position exhibits promising results in regards of graft function and limb salvage.Long term patency results and possible biodegeneration of the biological graft have to be awaited.