Clinical Research Studies
Long-term results of cryopreserved arterial allograft reconstruction in infected prosthetic grafts and mycotic aneurysms of the abdominal aorta*,**,*

https://doi.org/10.1067/mva.2001.116107Get rights and content
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Abstract

Purpose: This prospective, observational study determined the long-term outcome in patients with abdominal aortic infection (primary or prosthetic graft) who were treated with simultaneous aortic/graft excision and cryopreserved arterial allograft reconstruction. Methods: From April 1992 to March 2000, patients with abdominal aortic infection underwent complete or partial excision of the infected aorta/prosthetic graft and cryopreserved arterial allograft reconstruction. Arterial allografts were harvested from multiple organ donors and cryopreserved at –80°C without rate-controlled freezing. The patients were observed for survival, limb salvage, persistence and/or recurrence of infection, and allograft patency. The results were calculated with life-table methods. Results: During the 8-year study period, 28 consecutive patients (27 men, 1 woman; mean age, 64 years) underwent treatment for abdominal aortic infection (23 graft infections, including 7 graft-enteric fistulas and 5 primary aortic infections). Allograft reconstruction was performed as an emergency procedure in 13 patients (46%). The mean follow-up period was 35.4 months (range, 6-101 months). The overall treatment-related mortality rate was 17.8% (17% for graft infection, 20% for primary aortic infection). The overall 3-year survival was 67%. There was no early or late amputation. There was no persistent or recurrent infection, and none of the patients received long-term (> 3 months) antibiotic therapy. Reoperation for allograft revision, excision, or replacement was necessary in four patients (17%) who were available for examination, with no reoperative perioperative death. The 3-year primary and secondary allograft patency rates were 81% and 96%, respectively. Conclusion: Our experience with cryopreserved arterial allograft in the management of abdominal aortic infection suggests that this technique seems to be a useful option for treating one of the most dreaded vascular complications. (J Vasc Surg 2001;34:616-22.)

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Competition of interest: nil.

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Reprint requests: Guy Lesèche, MD, Service de Chirurgie Vasculaire et Thoracique, Hôpital Beaujon, 100 Boulevard du Général Leclerc, 92110 Clichy, France (e-mail: [email protected] ).

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Published online Jul 13, 2001.