Omniflow II biyosentetik greftlerle arteriyel revaskülarizasyonun uzun dönem sonuçları: tek merkez deneyimi

Yıl 2023, Cilt: 6 Sayı: 2, 210 - 214, 31.08.2023

Baran Şimşek , Davut Azboy , Zeki Temiztürk

https://doi.org/10.36516/jocass.1276127

Öz

Giriş: Bu çalışmanın amacı, Omniflow II biyosentetik greftlerle diz üstü femoropopliteal baypas

prosedürlerinin uzun dönem sonuçlarını analiz etmektir. Primer açıklık oranları ve greft ile ilişkili

komplikasyonlar çalışmanın ana hedefleri olarak belirlendi.


Gereç ve Yöntemler: Ocak 2012 ile Ocak 2021 arasında, toplam 50 hasta (42 erkek, 8 kadın) in-

situ Omniflow II greft kullanılarak revaskülarize edildi. Hastaların demografik, klinik, operatif ve

postoperatif özellikleri retrospektif olarak incelendi.


Sonuç: Ortalama yaş 63.8±10.1 (dağılım 40-82) idi. Elli hastaya diz üstü femoropopliteal bypass

operasyonu yapıldı. Dört hasta (%8) vasküler greft enfeksiyonu nedeniyle ameliyat edilirken, 8

hasta (%16) oklüde olmuş eski greftler nedeniyle ameliyat edildi. Primer açıklık oranı %88 idi.

Erken greft trombozu 2 (%4) hastada görülürken, 1 (%2) hastada proksimal ya da distal anastomoz

bölgeleriyle ilgisi olmayan geç dönem greft darlığına rastlandı. 12 (%24) hastaya anastomozun

proksimal veya distal bölgesinde endarterektomi uygulandı. Ortalama takip süresi 32.9±20.8 ay

(dağılım 12-90) idi. Üç hasta (%6) COVID-19 enfeksiyonu nedeniyle hayatını kaybetti. Greft

enfeksiyonu veya arteriyel baypas prosedürlerine bağlı mortalite ile karşılaşılmadı.


Tartışma: Omniflow II biyosentetik greft, diz üstü femoropopliteal baypas prosedürlerinde

yüksek açıklık oranları, düşük greft enfeksiyonu ve anevrizma oluşumu insidansı ile üstün ve

başarılı sonuçlar vermektedir.

Anahtar Kelimeler

Biyosentetik gerft, vasküler greft, revaskülarizasyon, periferik arter hastalığı

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

YOK

Long term results of arterial revascularization with Omniflow II biosynthetic grafts: a single center experience

Öz

Objective: The aim of this study is to analyze the long-term outcomes of above-knee femoro-popliteal bypass procedures with Omniflow II biosynthetic grafts. Primary patency and graft related complications were the end points of the study.
Methods: Between January 2012 and January 2021, a total of 50 patients (42 males, 8 females) were revascularized using an in-situ Omniflow II graft. Demographic, clinical, operative and postoperative characteristics of the patients were analyzed retrospectively.
Results: Mean age was 63.8±10.1 (range 40-82) years. Fifty above-knee femoropopliteal bypass procedures were performed. Four patients (8%) were operated on due to a previous vascular graft infection where 8 (16%) were operated on due to a previous occlusion. Primary patency rate was 88%. Early graft thrombosis occurred in 2 (4%) patients where late graft stenosis unrelated to the anastomotic sites was encountered in 1 (2%) patient. An endarterectomy on either the proximal or distal site of the anastomosis were performed in 12 (24%) patients. Mean follow-up was 32.9±20.8 (range 12-90) months. Three (6%) patients died due to a COVID-19 infection. No graft infection nor mortality related to arterial bypass procedures was encountered.
Conclusion: The Omniflow II biosynthetic graft provides superior results in treatment of above-knee femoro-popliteal bypass procedures with high patency rates and low incidence of graft infection and aneurysm formation

Anahtar Kelimeler

: Biosynthetic graft, vascular grafting, revascularization, peripheral arterial disease

Proje Numarası

YOK

Kaynakça

• 1. Shvedov A, Ivchenko A, Ivchenko O, et al. Clinical assessment of xenograft combined with knitted TiNi-based mesh implant in femoropopliteal bypass surgery: a Case Report. KnE Materials Science. 2017;2(1):410-417. https://doi.org/10.18502/kms.v2i1.827
• 2. Firnhaber JM, Powell CS. Lower extremity peripheral artery disease: Diagnosis and treatment. Am Fam Physician. 2019;99(6):362-369
• 3. Bevan GH, White Solaru KT. Evidence-based medical management of peripheral artery disease. Arterioscler Thromb Vasc Biol. 2020;40(3):541-553
• 4. Neufang A, Duenschede F, Espinola-Klein C, et al. Contemporary results with the biosynthetic glutaraldehyde denaturated ovine collagen graft (Omniflow II) in femoropopliteal position. J Vasc Surg. 2020;71(5):1630-1643
• 5. Ramshaw JAM, Werkmeister JA, Edwards GA. Tissue-Polymer Composite Vascular Prostheses. Encyclopedic Handbook of Biomaterials and Bioengineering, vol 2. New York: Marcel Dekker, 1995.
• 6. Edwards G, Roberts G. Development of an ovine collagen-based composite biosynthetic vascular prosthesis. Clin Mater. 1992;9:211-223
• 7. Raithel D, Noppeney T, Kasprzak P. Long term results of peripheral reconstruction with an ovine collagen prosthesis. J Cardiovasc Surg. 1989;30:91-92
• 8. Koch G, Gutschi S, Pascher O, et al. Femoropopliteal vascular replacement: vein, ePTFE or ovine collagen? Zentralbl Chir. 1996;121(9):761-767
• 9. Koch G, Gutschi S, Pascher O, et al. Analysis of 274 omniflow vascular prosthesis implanted over an eight-year period. Aust NZJ Surg. 1997;67(9):637-639
• 10. Braun R, Lin M. Acute limb ischemia: A case report and literature review. J Emerg Med. 2015;49(6):1011-1017
• 11. Wijnand JGJ, Zarkowsky D, Wu B, et al. The Global Limb Anatomic Staging System (GLASS) for CLTI: Improving inter-observer agreement. J Clin Med. 2021;10(16):3454
• 12. Blanchette V, Fernando ME, Shin L, et al. Evolution of WIfI: Expansion of WIfI notation after intervention. Int J Low Extrem Wounds. 2022:15347346221122860. doi: 10.1177/15347346221122860.
• 13. Toktaş F, Çayır MÇ, Özsin KK, et al. Long-term outcomes of Omniflow II biosynthetic vascular graft in lower extremity arterial revascularization. Turk Gogus Kalp Damar Cerrahisi Dergisi 2018;26(3):407-413
• 14. Keschenau PR, Gombert A, Barbati ME, et al. Xenogeneic materials for the surgical treatment of aortic infections. J Thorac Dis. 2021;13(5):3021-3032
• 15. Yoshida H, Sasajima T, Goh K, et al. Early results of a reinforced biosynthetic ovine collagen vascular prosthesis for small arterial reconstruction. Surg Today 1996;26:262-266
• 16. Mamode N, Scott RN. Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev 2000;2:CD001487
• 17. Pratesi C, Pulli R, Michelagnoli S. Early and late results of biosynthetic ovine carotid angioplasty. Int Angiol 1993;12:47-53
• 18. Palumbo R, Niscola P, Calabria S, et al. Long-term favorable results by arteriovenous graft with Omniflow II prosthesis for hemodialysis. Nephron Clin Prac 2009;113:c76-80
• 19. Moreira C, Leung A, Farber A, et al. Alternative conduit for infrageniculate bypass in patients with critical limb ischemia. J Vasc Surg. 2016;64:131-9.e1
• 20. Ziza V, Canaud L, Gandet T, et al. Outcomes of cold-stored venous allograft for below-knee bypasses in patients with critical limb ischemia. J Vasc Surg. 2015;62(4):974-983
• 21. Wilasrusmee C, Siribumrungwong B, Horsirimanont S, et al. Clinical results of biological prosthesis: A systematic review and meta- analysis of comparative studies. Ann Med Surg (Lond.) 2017;15:26-33
• 22. Kim Y, DeCarlo C, Jessula S, et al. Risk factors and consequences of graft infection after femoro-popliteal bypass: A 25-year experience. J Vasc Surg. 2022;76(1):248-254
• 23. Chakfe N, Diener H, Lejay A, et al. Editor’s choice-European Society for Vascular Surgery (ESVS) 2020 Clinical practice Guidelines on the management of vascular graft and endograft infections. Eur J Vasc Endovasc Surg. 2020;59:339-384
• 24.Wiltberger G, Matia I, Schmelzle M, et al. Mid-and long-term results after replacement of infected peripheral vascular prosthetic grafts with biosynthetic collagen prosthesis. J Cardiovasc Surg (Torino) 2014;55:693-698
• 25. Wozniak W, Kozinska A, Ciostek P, et al. Susceptibility of vascular implants to colonization in vitro by Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis and Pseudomonas aeruginosa. Pol J Microbiol 2017;66(1):125-129
• 26. Töpel I, Stigler T, Ayx I, et al. Biosynthetic grafts to replace infected prosthetic vascular bypasses: a single-center experience. Surgical infections. 2017;18(1):202-205
• 27. Etkin Y, Rao A, Jackson BM, et al. Infections of prosthetic grafts and patches used for infrainguinal arterial reconstructions. Ann Vasc Surg. 2019;57:152-159
• 28. Rossi PJ, Skelly CL, Meyerson SL, et al. Redo infrainguinal bypass: factors predicting patency and limb salvage. Ann Vasc Surg. 2003;17(5):492-502
• 29. Yamamoto S, Hoshina K, Kimura H, et al. Clinical analysis of non-anastomotic aneurysms of implanted prosthetic grafts. Surg Today 2014;44(10):1855-1862
• 30. Werkmeister JA, White JF, Edwards GA, et al. Early performance appraisal of the Omniflow II vascular prosthesis as an indicator of long-term function. J Long Term Eff Med Implants 1995;5:1-10
• 31. Van de Laar BC, van Heusden HC, Pasker-de Jong PC, et al. Omniflow II biosynthetic grafts versus expanded polytetrafluoroethylene grafts for infrainguinal bypass surgery. A single-center retrospective analysis. Vascular 2022;30(4):749-758