Use of Omniflow® II in Infected Vascular Grafts with Femoral Anastomotic Dehiscence

Siqueira, Jonathan R. De; Sun, Z D Y; Tahir, Wasif; Bhasin, Nikhil; Parry, D.J.

doi:10.1016/j.avsg.2019.10.050

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…Three patients required aortic intervention for false aneurysms, graft occlusion, and the development of a neoaortointestinal fistulation. 15 Low reinfection rates were also reported in a case series by Krazsnai et al 8 and De Siqueira et al 9 who used a biosynthetic collagen prosthesis to treat VGI in aortoiliac and femoral positions. In our cohort, the reinfection rate was 5.6% at a mean follow-up time of 26.6 months.…”

Section: Discussionmentioning

confidence: 67%

“…14 Nonetheless, experience with the use of biosynthetic collagen prosthesis to treat prosthetic aortic graft infection is still limited, and only case series with small numbers of patients have been reported until now. 8,9,24 However, the reinfection rates with this prosthesis in these studies are low. The study with the greatest number of patients was published in 2021 by El Beyrouti et al, who reported the outcome of 16 patients with aortic graft infection treated with biosynthetic grafts.…”

Section: Discussionmentioning

confidence: 74%

“…5 Furthermore, several authors reported encouraging results using biosynthetic collagen prosthesis for treating VGI in various arterial positions. [6][7][8][9][10] This group has previously published a case series in which a biosynthetic collagen prosthesis was used to treat aortic prosthetic graft infection; this case series focused on the feasibility and technical aspects of handling and applying the prosthesis. 11 The aim of this study was to report the midterm results of a biosynthetic collagen prosthesis as a treatment option for VGI and add corresponding follow-up data.…”

Section: Introductionmentioning

confidence: 99%

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Midterm outcome of biosynthetic collagen prosthesis for treating aortic and peripheral prosthetic graft infections

et al. 2021

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Objectives To report the midterm outcomes of treating prosthetic peripheral and aortic graft infections using a biosynthetic collagen prosthesis in a tertiary vascular center. Methods A retrospective analysis of all patients with prosthetic peripheral and aortic graft infections who underwent in situ reconstruction using a biosynthetic collagen prosthesis between March 2015 and November 2020 was conducted. Perioperative and midterm outcomes were analyzed. Results A biosynthetic collagen prosthesis was used in 19 patients (14 males, median age 66 years) to reconstruct the femoral artery ( n = 6), iliac artery ( n = 1), and infrarenal aorta ( n = 12). All patients were treated for a prosthetic vascular graft infection. The median follow-up period was 26.6 months (range 1–66 months). The 30-day graft failure rate was 15.7% ( n = 3), leading to a major amputation in one patient (5.3%). All grafts were occluded aortofemoral reconstructions in patients with occluded superficial femoral artery and were treated by immediate thrombectomy. The 30-day mortality rate was 5.3% ( n = 1), and survival after 3 years was 63.2%. The reinfection rate was 5.3% ( n = 1). At 13.6 months, the occlusion of a femoral graft was detected in 5.3% ( n = 1) and was treated with a new interposition graft. We observed no graft rupture or degeneration during follow-up. Conclusions Although results of in situ repair with autologous vein seem to be superior with little or none reinfection and low number of occlusions, biosynthetic collagen prostheses show acceptable midterm outcomes in terms of graft occlusion and mortality after prosthetic peripheral and aortic graft infections. Similar to other xenogenous materials, the reinfection rate is low with this prosthesis. With regard to immediate availability and easy handling, the use of a biosynthetic collagen prosthesis might be favorable compared to other replacement materials while treating prosthetic graft infections.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

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Midterm outcome of biosynthetic collagen prosthesis for treating aortic and peripheral prosthetic graft infections

et al. 2021

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“…[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. Our present report further confirms the satisfactory resistance of the Omniflow II material to infection, is also in line with the recently reported acceptable rates of graft patency and success in limb salvage, 1 and endorses the practice of replacing infected prosthetic vascular grafts with the Omniflow II vascular prostheses.…”

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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“…[1] Anastomotic pseudoaneurysm is a late complication secondary to graft materials dehiscence due to degeneration that reported in 1 to 5% of cases, and plenty of them are related to infection with Staphylococcus species being the main organism in the culture results. [2][3][4][5] Injury of the lymphatic system during dissection may cause lymphorrhea, lymph fistula, or lymphocele. [6] There is no consensus on the effective treatment of postoperative lymphorrhea or lymphocele.…”

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confidence: 99%

A giant anastomotic late pseudoaneurysm of aortobifemoral graft in the groin: Treatment and management of complications

Akça¹

2021

Turk J Vasc Surg

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Anastomotic pseudoaneurysm is a late complication secondary to graft materials dehiscence due to degeneration, and the femoral artery is riskier than others. Surgical repair is usually recommended for femoral pseudoaneurysms of >2 cm. Redo surgery of the groin brings an ascending risk of lymphorrhea or lymphocele, a condition which has no consensus on the effective treatment. In this article, we present the treatment and management of complications of a rare, non-infected giant left groin anastomotic pseudoaneurysm due to late graft dehiscence in a patient who underwent aortobifemoral graft 20 years ago for Leriche syndrome.

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Use of Omniflow® II in Infected Vascular Grafts with Femoral Anastomotic Dehiscence

Cited by 7 publications

References 20 publications

Midterm outcome of biosynthetic collagen prosthesis for treating aortic and peripheral prosthetic graft infections

Midterm outcome of biosynthetic collagen prosthesis for treating aortic and peripheral prosthetic graft infections

Ovine Biosynthetic Grafts for Aortoiliac Reconstructions in Nonsterile Operative Fields

A giant anastomotic late pseudoaneurysm of aortobifemoral graft in the groin: Treatment and management of complications

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