Use of biosynthetic prosthesis (Omniflow II®) to replace infected infrainguinal prosthetic grafts - first results

Töpel, I.; Betz, Thomas; Uhl, Christian; Wiesner, M.; Bröckner, Stefan; Steinbauer, Markus

doi:10.1024/0301-1526/a000188

Cited by 39 publications

(21 citation statements)

References 5 publications

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“…If associated with the anastomosis, the graft should be removed and the native vessels repaired. If the infected aneurysm is localized and in the mid graft, some authors have suggested excision of the affected area and repair with a biological or biosynthetic graft although this has been described in bypass rather than in VA [ 42 ].…”

Section: Managementmentioning

confidence: 99%

Aneurysms and pseudoaneurysms in dialysis access

Mudoni¹,

Cornacchiari²,

Gallieni

et al. 2015

Clin Kidney J

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Aneurysms are a common and often difficult complication seen with arteriovenous vascular access for haemodialysis. The purpose of this narrative review is to define and describe the scale of the problem and suggested therapeutic strategies. A narrative review of the published literature illustrated by individual cases is presented with the aim of summarising the relevant literature. The definitions of aneurysm are inconsistent throughout the literature and therefore systematic review is impossible. They vary from qualitative descriptions to quantitative definitions using absolute size, relative size and also size plus characteristics. The incidence and aetiology are also ill defined but separation into true aneurysms and false, or pseudoaneurysms may be helpful in planning treatment, which may be conservative, surgical or radiological. The lack of useful definitions and classification along with the multitude of management strategies proposed make firm evidence based conclusions difficult to draw. Further robust well designed studies are required to define best practice for this common problem.

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Section: Managementmentioning

confidence: 99%

Aneurysms and pseudoaneurysms in dialysis access

Mudoni¹,

Cornacchiari²,

Gallieni

et al. 2015

Clin Kidney J

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“…The plan was to remove the femoro-femoral bypass and the femoral-popliteal bypass and replace both with biological Omniflow grafts and repair both aneurysms. This decision is supported by a prospective study in 2012 showing that biological grafts were not reinfected up to 20 months after the operation 21 . However they did report that the mechanical properties of these grafts may be disadvantageous and more prone to kinking and obstruction.…”

Section: Managementmentioning

confidence: 98%

Management of Vascular Graft Infection

Ward

Howard²

2020

JNDS

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This case report focuses on the risk factors, diagnosis, and management of vascular graft infections. A complex and intriguing case is presented and the latest evidence on aetiology and management of this challenging condition are summarised. The contention regarding the diagnostic criteria for graft infection is addressed, and how different imaging modalities and genetic or systemic biomarkers could aid this diagnostic process. Key management challenges are also discussed. Firstly, the difficulties of penetration and efficacy of antimicrobials and the issues surrounding biofilm formation. Secondly, the different surgical options such as graft preservation with partial excision or muscle flap coverage, or excision and revascularisation. Further, the type of explant and the latest innovations in the field of biological grafts are considered. Overall, this case report brings to the fore the lack of structured guidelines and level 1 evidence for the diagnosis and management of vascular graft infection, and calls for a more structured, unified, multi-disciplinary approach.

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“…Bovinný xenograft je potenciálne viac imunoalergénny ako ľudský allograft. Napriek tomu, že pri použití xenoperikardiálnych a iných xenoimplantátov boli dosiahnuté dobré krátodobé výsledky, 19 zatiaľ chýbajú klinické štúdie, ktoré by dlhodobú úspešnosť použitia týchto preparátov potvrdili.…”

Section: Diskusiaunclassified

(Infected thoracic stentgraft and prosthetic graft with replacement by human aortic allograft)

Sihotský¹,

Berek²,

Mathews³

et al. 2019

Cor Vasa

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Úvod: Popisujeme prípad úspešnej náhrady protézy descendentnej aorty a implantovaného hrudného stentgraftu humánnym aortálnym allograftom. Kazuistika: Jednalo sa o 47 ročného muža, ktorý bol v šestnástich rokoch operovaný pre koarktáciu aorty. Mal vykonaný dakronový bypass z descendentnej aorty nad koarktáciou na infrarenálnu aortu. Po tridsiatich rokoch sa u neho vytvorila pseudoaneuryzma v proximálnej anastomóze, ktorá bola prvotne riešená implantáciou hrudného stentgraftu. Avšak osem mesiacov po implantácii hrudného stentgraftu dochádza k rozvoju infekcie. Vykonali sme explantáciu hrudného stentgraftu a pôvodnej dakronovej protézy. Infi kovanú descendentnú aortu sme nahradili in situ čerstvým aortálnym allograftom. Pooperačný priebeh bol bez komplikácií a pacient je aktuálne bez známok sepsy, viscerálnej ischémie alebo klaudikácií. Záver: Metódou voľby liečby infi kovaného stentgraftu je jeho odstránenie. Problémom ostáva náhrada infi kovanej aorty po explantácii stentgraftu. Extraanatomický bypass "aorta ventrale" už v súčasnosti nie je metódou voľby. Náhrada infi kovanej oblasti aortálnym allograftom zostáva jednou z najviac používaných možností. Medzi komplikácie tohto postupu môže byť aneuryzmatická dilatácia náhrady, jej stenóza alebo uzáver. Tieto komplikácie sa vyskytujú do 20 % prípadov. Ďalšou z moderných možností liečby je in situ náhrada xenoperikardiálnym graftom. Operačná mortalita týchto operácii je vysoká, do 30 %. No aj napriek vysokej mortalite týchto operácií je chirurgická liečba nutná, lebo takmer všetci neliečení pacienti umierajú.

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Use of biosynthetic prosthesis (Omniflow II®) to replace infected infrainguinal prosthetic grafts - first results

Abstract: In the absence of appropriate autologous material biosynthetic grafts seem to be a possible alternative to replace infected infrainguinal grafts. The different mechanical properties of biosynthetic grafts may be of certain disadvantage in infragenicular reconstructions.

Cited by 39 publications

References 5 publications

Aneurysms and pseudoaneurysms in dialysis access

Aneurysms and pseudoaneurysms in dialysis access

Management of Vascular Graft Infection

(Infected thoracic stentgraft and prosthetic graft with replacement by human aortic allograft)

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