Evaluation of glutaraldehyde-tanned human umbilical cord vein as a vascular prosthesis for bypass to the popliteal, tibial, and peroneal arteries.

One hundred and thirty-one reconstructions to the popliteal (n = 80), tibial (n = 26), and peroneal (n = 25) arteries were performed using glutaraldehyde (GA)-tanned human umbilical cord veins. Cumulative patency rates to 20 months, calculated by the standard life-table method were 84.8%, 74.0%, and 49.6% for popliteal, tibial, and peroneal reconstructions, respectively. The latter included many of the early cases with extremely advanced obliterative atherosclerosis and gangrene. These results are equivalent and even superior to those obtained with saphenous veins, particularly when the cases are analyzed in distinct clinical and pathological categories. The quality of the runoff was the major determinant in obtaining long-term patency and limb function. The primary factor accounting for graft closure was progression of the atherosclerotic process in the distal circulation. No failures could be attributed directly to the graft. This clinical experience confirmed previous data showing the unique properties of the GA-tanned umbilical vein. It is anticipated that longer-term follow-up will continue to show the superior qualities of this new vascular substitute.