De Siqueira Jonathan R, Sun Zoe D Y, Tahir Wasif, Bhasin Neeraj, Parry Duncan
Department of Vascular Surgery, Huddersfield Royal Infirmary, Huddersfield, UK.
Department of Vascular Surgery, Huddersfield Royal Infirmary, Huddersfield, UK.
Ann Vasc Surg. 2020 May;65:160-165. doi: 10.1016/j.avsg.2019.10.050. Epub 2019 Oct 24.
Vascular graft infection with anastomotic dehiscence requires immediate surgical intervention to preserve life and limb. We present our experience of using the Omniflow® II biosynthetic vascular prosthesis (LeMaitre Vascular) in the emergency repair of vascular graft dehiscence at the femoral anastomosis.
A retrospective review of consecutive patients presenting with femoral anastomotic dehiscence in a single centre was conducted. All patients were revascularized using an in situ Omniflow II graft. Patient demographics, affected graft type, microbiology, and antibiotic regimes were documented. Primary outcome measures were limb salvage, patency rates, and mortality.
Five patients presented with acute femoral false aneurysm and four of five with significant hemorrhage. Infected grafts included one aortobifemoral, two femoral crossover, one axillobifemoral, and one infrainguinal reversed vein graft. All were revascularized with an in situ Omniflow II graft following the excision of the infected graft material. The median followup was 50 months. Limb salvage was achieved in 8 of 9 threatened limbs, and none required further intervention for re-infection. One graft occluded at 5 months. Two of five patients died during followup (one at 12 months, one at 50 months).
Omniflow II provides a useful "off-the-shelf" conduit for the urgent revascularization of infected femoral dehiscence.
血管移植感染合并吻合口裂开需要立即进行手术干预以挽救生命和肢体。我们介绍了使用Omniflow® II生物合成血管假体（LeMaitre Vascular公司）紧急修复股动脉吻合口血管移植裂开的经验。
对单一中心连续出现股动脉吻合口裂开的患者进行回顾性研究。所有患者均使用原位Omniflow II移植物进行血管重建。记录患者的人口统计学资料、受感染移植物类型、微生物学情况及抗生素使用方案。主要观察指标为肢体挽救情况、通畅率和死亡率。
5例患者出现急性股动脉假性动脉瘤，其中4例伴有严重出血。受感染的移植物包括1例主动脉双股动脉移植物、2例股动脉交叉移植物、1例腋双股动脉移植物和1例腹股沟下静脉翻转移植物。在切除受感染的移植物材料后，所有患者均使用原位Omniflow II移植物进行血管重建。中位随访时间为50个月。9条受威胁肢体中有8条实现了肢体挽救，且无一例因再次感染需要进一步干预。1例移植物在5个月时闭塞。5例患者中有2例在随访期间死亡（1例在12个月时，1例在50个月时）。
Omniflow II为感染性股动脉吻合口裂开的紧急血管重建提供了一种有用的“现货”管道。
