Biosynthetic Grafts To Replace Infected Prosthetic Vascular Bypasses: A Single-Center Experience.

Background: There are only a few options to replace infected infrainguinal synthetic vascular grafts in the absence of suitable autologous veins. To use a biosynthetic vascular graft (OmniflowII) might be a valuable alternative.

Methods: We retrospectively analyzed the clinical course of 29 patients who underwent replacement of an infected infrainguinal vascular prosthesis (Szilagyi 3) by an OmniflowII graft.

Results: Because of the lack of suitable autologous veins, 15 above-knee femoro-popliteal, 5 below-knee femoro-popliteal, and 9 femoro-tibial bypasses were replaced with biosynthetic grafts. There were no in-hospital deaths, reinfections, or major amputations. The survival rate was 92% at one year and 87% at two years. During follow-up (median 24 months; range 5-66 months), no reinfections occurred. However, nine patients presented with bypass occlusions (primary patency 67.6% at one year and 61.5% at two years; secondary patency 85.3% at one year and 69% at two years). The limb salvage rate was 89% at one year and 83% at two years.

Conclusion: Biosynthetic bypass grafts might be valuable to replace infected prosthetic grafts in the absence of a suitable vein. They have excellent re-infection resistance. Limb salvage, morbidity, and the mortality rate are similar to those obtained with autologous vein grafts in infected fields.