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Biosynthetic Grafts To Replace Infected Prosthetic Vascular Bypasses: A Single-Center Experience
Ingolf Töpel1, Theresa Stigler1, Isabelle Ayx2
11 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg , Regensburg, Germany .
Background:
There are only a few options to replace infected infrainguinal synthetic vascular grafts in the absence of suitable autologous veins. To use a biosynthetic vascular graft (Omniflow®II) might be a valuable alternative.
Methods:
We retrospectively analyzed the clinical course of 29 patients who underwent replacement of an infected infrainguinal vascular prosthesis (Szilagyi 3) by an Omniflow®II graft.
Results:
Because of the lack of suitable autologous veins, 15 above-knee femoro-popliteal, 5 below-knee femoro-popliteal, and 9 femoro-tibial bypasses were replaced with biosynthetic grafts. There were no in-hospital deaths, reinfections, or major amputations. The survival rate was 92% at one year and 87% at two years. During follow-up (median 24 months; range 5-66 months), no reinfections occurred. However, nine patients presented with bypass occlusions (primary patency 67.6% at one year and 61.5% at two years; secondary patency 85.3% at one year and 69% at two years). The limb salvage rate was 89% at one year and 83% at two years.
Conclusion:
Biosynthetic bypass grafts might be valuable to replace infected prosthetic grafts in the absence of a suitable vein. They have excellent re-infection resistance. Limb salvage, morbidity, and the mortality rate are similar to those obtained with autologous vein grafts in infected fields.
