Long-Term Results of Biological Grafts for Haemodialysis Vascular Access

Inston, Nicholas

doi:10.5301/jva.5000355

Cited by 4 publications

(3 citation statements)

References 54 publications

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“…[15][16][17][18] This particular composition is reported to enable revascularization of the graft wall, thus contributing to prevention of infection. [19][20][21] The Omniflow II vascular prostheses have been reported to have favorable properties in resisting infections when used to treat infected peripheral prosthetic vascular grafts, and frequencies of reinfection with the Omniflow II vascular prostheses were reported to be better than those associated with alternative graft materials used for in situ reconstruction of infected vascular grafts such as standard polyester grafts, cryopreserved allografts, rifampicin-bonded prostheses, autogenous veins, and silver-coated prostheses. 6,11,19,[22][23][24] These advantageous properties were credited to rapid tissue integration and neovascularization of graft wall, 19 and reports to date indicate that the occasional reinfections are more likely to result from the retained stumps of the infected grafts rather than the Omniflow II material per se.…”

Section: Discussionmentioning

confidence: 99%

Ovine Biosynthetic Grafts for Aortoiliac Reconstructions in Nonsterile Operative Fields

Beyrouti

Izzat

Kornberger

et al. 2021

Thorac Cardiovasc Surg

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Background Prosthetic vascular grafts placed surgically or via endovascular techniques can be subject to the risk of life-threatening graft infections. The Omniflow II vascular prosthesis is a biosynthetic graft that was reported to have favorable properties in resisting infections. Materials and Methods We retrospectively reviewed our 3 years' experience of using the Omniflow II prostheses for aortoiliac reconstructions in patients considered to carry a substantial risk of subsequent prosthetic graft infections (prevention group) as well as in patients with actively infected prosthetic vascular grafts (treatment group). Results Aorto-bi-iliac (n = 4) and aortobifemoral (n = 12) vascular reconstructions were performed using bifurcated Omniflow II prostheses in nine patients in the prevention group and seven patients in the treatment group. During mean follow-up of 28.6 ± 17.2 months, there was one case of graft infection (6.3%) and graft thrombosis (6.3%) with subsequent successful thrombectomy. Early and late surgical revisions were required in eight (50%) and two (12.6%) patients, respectively. All graft prostheses were patent at last follow-up. Conclusion Using bifurcated Omniflow II vascular prostheses in patients with or at a high risk of vascular graft infection is advisable, and is associated with acceptable reinfection and patency rates.

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Section: Discussionmentioning

confidence: 99%

Ovine Biosynthetic Grafts for Aortoiliac Reconstructions in Nonsterile Operative Fields

Beyrouti

Izzat

Kornberger

et al. 2021

Thorac Cardiovasc Surg

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“…Data from biological grafts are sparse, but may historically represent manufacturing issues. Modern biological grafts do not appear to have a high rate of aneurysm formation (38).…”

Section: Incidence and Natural Historymentioning

confidence: 99%

Aneurysms in Vascular Access: State of the Art and Future Developments

et al. 2017

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A master class was held at the Vascular Access at Charing Cross (VA@CX2017) conference in April 2017 with invited experts and active audience participation to discuss arteriovenous (AV) vascular access aneurysms, a serious and common complication of vascular access (VA). The natural history of aneurysms in VA is poorly defined, and although classifications exist they are not uniformly applied in studies or clinical practice. True and pseudo aneurysms of AV access occur. Whilst an AV fistula by definition is an abnormal dilatation of a blood vessel, an agreed definition of 18 mm, or 3 times accepted maturation diameter, is proposed. The mechanism of aneurysmal dilatation is unknown but appears to be a combination of excessive external remodeling, wall changes due to injury, and obstruction of outflow. Diagnosis of AV aneurysms is based on physical examination and ultrasound. Venography and cross-sectional imaging may assist and be required for the investigation of outflow stenosis. Treatment of pseudo aneurysms and true aneurysms of VA (AVA) is not evidence-based, but relies on clinical experience and available facilities. In many AVA, a conservative approach with surveillance is suitable, although intervals and modalities are unclear. Avoidance of rupture is imperative and preemptive treatment should aim for access preservation, ideally with avoidance of prosthetic materials. Different techniques of aneurysmorrhaphy are described with good results in published series. Although endovascular approaches and stenting are described with good short-term results, issues with cannulation of stented areas occur and, while possible, this is not recommended, and long-term access revision is recommended.

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“…A biosynthetic graft, the Omniflow II consists of a glass mandrel mounted polyester skeletal core. This is implanted subcutaneously into adult sheep for 12-14 weeks then explanted, de-cellularized with glutaraldehyde and stored in a liquid medium with good long-term shelf life (9). It has been shown in histological studies to incorporate into the local tissues leading to recellularization and neo-vascularization (10).…”

Section: Introductionmentioning

confidence: 99%