[Venous homografts as femoro-popliteal bypasses or as vascular access routes in chronic hemodialysis].

Saphenous vein homografts preserved by freezing at 40 degrees C in the presence of antibiotics for periods of as much as six months were implanted as part of a clinical evaluation program. Candidates included one requiring femoro-popliteal reconstruction with two separate bypass procedure and reoperations for thrombosis and false aneurysm in the left limb as well as 23 maintenance hemodialysis patients (32 arteriovenous blood access shunts for a total of 424 patient-months). Explanted veins used as femoro-popliteal bypasses were examined after collection incidental to reoperations and autopsy. In-vivo dwell time varied between 7 and 51 months. The femoro-popliteal by-passes exhibited calcification and sclerosis. The dialysis access shunts had average service lives of about a year; 21 were replaced because of thrombosis, 10 were stenosed, 7 had aneurysms and necrosis was present in six. Although this implant provides a workable alternative approach to vascular reconstruction, the rapid degeneration of such veins in vivo is a limitation.