title: Biosynthetic Grafts To Replace Infected Prosthetic Vascular Bypasses: A Single-Center Experience.
abstract: 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 (Omniflow®II) 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 Omniflow®II 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg , Regensburg, Germany .
authors.forename: Ingolf
authors.initials: I
authors.lastname: Töpel
authors.affiliation: 1 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg , Regensburg, Germany .
authors.forename: Theresa
authors.initials: T
authors.lastname: Stigler
authors.affiliation: 2 Department of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Krankenhaus Barmherzige Brüder Regensburg , Regensburg, Germany .
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ayx
authors.affiliation: 1 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg , Regensburg, Germany .
authors.forename: Thomas
authors.initials: T
authors.lastname: Betz
authors.affiliation: 1 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg , Regensburg, Germany .
authors.forename: Christian
authors.initials: C
authors.lastname: Uhl
authors.affiliation: 1 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg , Regensburg, Germany .
authors.forename: Markus
authors.initials: M
authors.lastname: Steinbauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012189:Retrospective Studies