Contemporary results with the biosynthetic glutaraldehyde denatured ovine collagen graft (Omniflow II) in femoropopliteal position

Neufang, A.; Duenschede, Fritz; Espinola‐Klein, Christine; Weißer, Gerhard; Savvidis, Savvas; Poplawski, Alicia; Vahl, Christian F.; Dorweiler, Bernhard

doi:10.1016/j.jvs.2019.08.234

Cited by 22 publications

(22 citation statements)

References 26 publications

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“…The Omniflow ® II graft, consisting of an ovine collagen matrix on a polyester mesh, seems to be a promising alternative for such cases. Although concerns about its resistance to bacterial colonization have been raised in an in vitro study (27), results from clinical practice, most of which regard peripheral arterial reconstructions, have shown a good infection resistance so far (10)(11)(12)30). Moreover, excellent early to midterm patency without reinfection has been reported in a case series using the Omniflow ® II graft for reconstruction of the aortic bifurcation alone or in combination with a bovine pericardium tube (31) and its usefulness in reconstructing the aortic arch in the event of infection has also been demonstrated (8).…”

Section: Discussionmentioning

confidence: 99%

“…Most publications on xenogeneic reconstructions for AIs report the use of bovine pericardium (5,(7)(8)(9). Another option is the biosynthetic Omniflow ® II graft, for which favorable results have been shown when used for peripheral arterial reconstructions in an infected field (10,11). However, only few studies describe its use in the aortoiliac segment (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Xenogeneic materials for the surgical treatment of aortic infections

Keschenau¹,

Gombert²,

Barbati³

et al. 2021

J Thorac Dis

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Background: The surgical treatment of aortic infections (AIs) is challenging. In situ aortic reconstructions represent nowadays the favored therapy for fit patients and xenogeneic materials are used increasingly. The aim of this study was to present our experience with xenogeneic reconstructions for AI using self-made bovine pericardium tubes and/or the biosynthetic Omniflow ® II graft. Methods: This retrospective single-center study included all patients undergoing xenogeneic aortic and aortoiliac reconstructions from December 2015 to June 2020. Patient comorbidities, symptoms, procedural characteristics, types of pathogens and postoperative outcomes were analyzed. Results: Twenty-eight patients [23 male (82%), median age 68 (range, 28-84) years] were included. Ten patients (36%) had native AIs and 18 (64%) had graft infections, including 3 (11%) aortoesophageal and 2 (7%) aortoduodenal fistulas (ADF). Twenty-four patients (86%) were symptomatic, the most common symptoms being contained aortic rupture (n=8) and sepsis (n=4). The surgical procedures were infra-and juxtarenal aortic repairs (n=11, 39% and n=7, 25%), thoracoabdominal aortic repairs (type IV: n=1, 4%; type V: n=3, 11%), descending thoracic aortic repairs (n=4, 14%) and 2 reconstructions (7%) involving the ascending aorta/aortic arch. Most were urgent (n=10, 43%) or emergent operations (n=11, 35%). Identification of pathogen(s), mostly Gram-positive bacteria, was possible in 25 patients (89%). Twelve patients (43%) had polymicrobial infections and 6 (21%) infections with multi-resistant bacteria. In-hospital mortality was 32% (n=9) due to acute cardiac failure (1/9), endocarditis (1/9), bleeding (3/9) and sepsis (4/9). The most frequent complications were transient need for dialysis (n=12, 43%) and persisting sepsis (n=11, 39%). Two early occlusions of Omniflow ® II grafts were observed (7%). Median follow-up (FU), during which 2 patients died of non-aortic causes, was 14 months (95% CI: 9-19 months). Freedom from reoperation was 100%, there was no evidence for reinfection during FU. Conclusions: Xenogeneic orthotopic reconstructions for AI can be performed at all aortic levels.Combining bovine pericardium and the Omniflow ® II graft can be useful for reconstructing the branched aortic segments and both materials show appropriate early to midterm outcomes. Nonetheless, AIs are serious conditions associated with relevant morbidity/mortality rates, even in a specialized center.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Xenogeneic materials for the surgical treatment of aortic infections

Keschenau¹,

Gombert²,

Barbati³

et al. 2021

J Thorac Dis

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“…No late graft infections are reported. 3,4,8,9 Neufang et al reported 4 out of 205 bypasses (1.9%) to be involved in deep wound infection or infected hematoma. In all cases, the Omniflow II was exposed due to wound dehiscence, but could be preserved.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The role of Omniflow II in the prevention of VGI is not well studied. 3,4 Early infection (<30 days) of Omniflow II has been reported. 3,5 Until now, no reports of late infection are reported.…”

Section: Introductionmentioning

confidence: 99%

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Late hematogenous seeding and infection of a femoropopliteal Omniflow II bypass

et al. 2020

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Introduction Omniflow II is promoted as an infection-resistant vascular graft. It is used to treat vascular graft infection; nevertheless, early graft infection has been reported. Report: A 71-year-old patient was treated with an Omniflow II bypass for a non-healing diabetic foot ulcer. Seven months postoperatively, late infection occurred secondary to hematogenous spread from a persistent foot infection. Conclusion We report on the first case of late infection of an Omniflow II vascular graft caused by hematogenous spread. Despite promising results of the Omniflow II graft in the treatment of vascular graft infection, late infection may not be avoided.

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Chirurgische Behandlungsverfahren des diabetischen Fußsyndroms

Neufang

2022

Klinische Angiologie

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Contemporary results with the biosynthetic glutaraldehyde denatured ovine collagen graft (Omniflow II) in femoropopliteal position

Cited by 22 publications

References 26 publications

Xenogeneic materials for the surgical treatment of aortic infections

Xenogeneic materials for the surgical treatment of aortic infections

Late hematogenous seeding and infection of a femoropopliteal Omniflow II bypass

Chirurgische Behandlungsverfahren des diabetischen Fußsyndroms

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