Fresh From the Freezer: A Single-center Experience Using Cryopreserved Superficial Femoral Artery Allografts in Infrainguinal Revascularization for Limb Salvage

Cryopreserved superficial femoral artery (Cryo-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 Cryo-SFA is a relatively less explored option. This study aims to assess the postoperative outcomes and patency of the Cryo-SFA conduit for infrainguinal revascularization. Between February 2015 and May 2022, 34 patients underwent infrainguinal bypass using Cryo-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. The mean age of our cohort was 67 ± 10 years, and 20 (59%) were male; 18 (53%) were White, 30 (88%) had hypertension, 20 (59%) had diabetes, eight (24%) had chronic obstructive pulmonary disease (COPD), and eight (24%) were current smokers. Twenty-one (62%) were redo operations. Indications for the index operation included rest pain (21%), tissue loss (38%), and infection (21%). Distal targets included profunda/superficial femoral artery (12%), popliteal (29%), tibial (47%), and peroneal (12%). At 30 days, 33 of 34 grafts were patent (97%); three amputations (9%), two readmissions (6%), and nine (26%) unplanned returns to the operating room had occurred. Estimated overall 1-year primary patency was 50%. The amputation rate overall was 35%. Our results highlight that Cryo-SFA has patency rates comparable to those previously published for prosthetic bypass conduits, even in our cohort with high rates of redo bypasses. Cryo-SFA may be a reasonable choice for infrainguinal revascularization and limb salvage in patients who had failed prior revascularization options and lacked autogenous conduit.