A systematic review and meta-analysis of the use of the Omniflow II biosynthetic graft for aortic reconstruction

El-Diaz, Nadia; Walker-Jacobs, Abigail; Althaher, Ahmad; Alalwani, Zara; Borucki, Joseph; Stather, Philip

doi:10.1016/j.jvs.2022.09.009

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Various groups have published their experiences with specific materials used for reconstruction, mostly for the abdominal aorta, with a lack of direct comparisons. The ESVS guidelines, as well as current meta-analyses, have summarized short-term mortality rates and reinfection rates for biological (pericardium, homograft), prosthetic (silver-coated, biosynthetic) and autologous vein vascular substitutes (VS) [ 3 , 16 , 35 ]. Generally, mortality rates are almost equal, while resistance to infection might be better for biological and venous VS.…”

Section: Discussionmentioning

confidence: 99%

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Puttini,

Kapalla,

Braune

et al. 2024

JCM

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Vascular graft/endograft infection (VGEI) is a serious complication after aortic surgery. This study investigates VGEI and patient characteristics, PET/CT quantification before surgical or conservative management of VGEI and post-intervention outcomes in order to identify patients who might benefit from such a procedure. PET standard uptake values (SUV) were quantitatively assessed and compared to a non-VGEI cohort. The primary endpoints were in-hospital mortality and aortic reintervention-free survival at six months. Ninety-three patients (75% male, 65 ± 10 years, 82% operated) were included. The initial operation was mainly for aneurysm (67.7%: 31% EVAR, 12% TEVAR, 57% open aortic repair). Thirty-two patients presented with fistulae. PET SUVTLR (target-to-liver ratio) showed 94% sensitivity and 89% specificity. Replacement included silver-coated Dacron (21.3%), pericardium (61.3%) and femoral vein (17.3%), yet the material did not influence the overall survival (p = 0.745). In-hospital mortality did not differ between operative and conservative treatment (19.7% vs. 17.6%, p = 0.84). At six months, 50% of the operated cohort survived without aortic reintervention. Short- and midterm morbidity and mortality remained high after aortic graft removal. Neither preoperative characteristics nor the material used for reconstruction influenced the overall survival, and, with limitations, both the in-hospital and midterm survival were similar between the surgically and conservatively managed patients.

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Section: Discussionmentioning

confidence: 99%

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Puttini,

Kapalla,

Braune

et al. 2024

JCM

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“…The freedom from reinfection was 97.71% (95% CI, 87.94%-100%). They also concluded that using a biosynthetic graft for in situ aortic reconstruction in infected fields is a feasible option, with acceptable mortality and low reinfection rates, but with a risk of limb occlusion (6.2%; 95% CI, 0.39%-15.81%) [49]. Despite improvements in outcomes, graft reinfection remains a serious clinical concern.…”

Section: ) Surgical Treatmemtmentioning

confidence: 99%

“…Biosynthetic vascular grafts are a new type of conduit consisting of a bovine collagen matrix on a polyester mesh. It has been used for in situ aortic reconstruction in patients with an infected aorta [ 48 , 49 ]. According to a recently published systematic review regarding the biosynthetic graft (Omniflow II, LeMaitre) used for aortic reconstructions (n=60), early mortality was 9% (95% CI, 1.12%-20.53%) and late mortality was 18% (95% CI, 5.51%-35.34%) [ 49 ].…”

Section: Treatment Of Aeimentioning

confidence: 99%

“…It has been used for in situ aortic reconstruction in patients with an infected aorta [ 48 , 49 ]. According to a recently published systematic review regarding the biosynthetic graft (Omniflow II, LeMaitre) used for aortic reconstructions (n=60), early mortality was 9% (95% CI, 1.12%-20.53%) and late mortality was 18% (95% CI, 5.51%-35.34%) [ 49 ]. No graft rupture or degeneration occurred during the follow-up period of 9 to 24 months.…”

Section: Treatment Of Aeimentioning

confidence: 99%

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Aortic Endograft Infection: Diagnosis and Management

Kim

2023

Vasc Specialist Int

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Aortic endograft infection (AEI) is a rare but life-threatening complication of endovascular aneurysm repair (EVAR). The clinical features of AEI range from generalized weakness and mild fever to fatal aortic rupture or sepsis. The diagnosis of AEI usually depends on clinical manifestations, laboratory tests, and imaging studies. Management of Aortic Graft Infection Collaboration (MAGIC) criteria are often used to diagnose AEI. Surgical removal of the infected endograft, restoration of aortic blood flow, and antimicrobial therapy are the main components of AEI treatment. After removing an infected endograft, in situ aortic reconstruction is often performed instead of an extra-anatomic bypass. Various biological and prosthetic aortic grafts have been used in aortic reconstruction to avoid reinfection, rupture, or occlusion. Each type of graft has its own merits and disadvantages. In patients with an unacceptably high surgical risk and no evidence of an aortic fistula, conservative treatment can be an alternative. Treatment results are determined by bacterial virulence, patient status, including the presence of an aortic fistula, and hospital factors. Considering the severity of this condition, the best strategy is prevention. When encountering a patient with AEI, current practice emphasizes a multidisciplinary team approach to achieve an optimal outcome.

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Rerouting in vascular access infections using a biosynthetic vascular graft (Omniflow® II)

Müller,

Kohler,

Weiss

et al. 2023

Gefässchirurgie

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Background Surgical treatment of infected arteriovenous grafts (AVG) while preserving the hemodialysis access remains a challenge. Partial graft excision (PGE) directly followed by interposition grafting (IG) is an established method but is associated with a high rate of local reinfection. This retrospective study investigated the technique of rerouting using a biosynthetic vascular graft (Omniflow® II). Methods This was a retrospective analysis of all patients at a tertiary referral center undergoing surgical treatment for AVG infections using PGE and IG with the rerouting technique using Omniflow® II between January 2009 and December 2018. Follow-up data were collected until May 2021. Results Fifteen patients (53% male, median age 62 years [range 49-81]) were identified for further analysis, thereof twelve received an Omniflow® II vascular graft. Eleven patients had positive local microbial cultures, with Staphylococcus aureus being the most frequently identified pathogen (9 cases). Mortality and reoperation rates within 30 days were both 0%. Median follow-up was 32 months (range 2–101 months) with a median follow-up index of 0.92 (range 0.18–1). During follow-up a surgical intervention for reinfection was necessary in 3 patients with Omniflow® II at a median of 304 days (range 298–485 days). Conclusion Partial graft excision and direct interposition grafting using a biosynthetic Omniflow® II vascular graft is a valid treatment option in selected patients with AVG infections when total graft excision can be avoided. Using a careful rerouting technique, while preserving clinically noninfected graft sections the risk of early reinfection can be minimized and the dialysis access maintained.

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A systematic review and meta-analysis of the use of the Omniflow II biosynthetic graft for aortic reconstruction

Cited by 5 publications

References 23 publications

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Aortic Endograft Infection: Diagnosis and Management

Rerouting in vascular access infections using a biosynthetic vascular graft (Omniflow® II)

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