Abstract
BackgroundIn general, autologous veins are the optimal replacement material for an infected vascular graft in terms of handling, durability and resistance to reinfection. In the absence of suitable autologous material, several options are available, each of which has specific advantages and drawbacks with regard to these characteristics.MethodsIn recent years, xenogeneic materials (in particular pericardial patches from different species and biosynthetic grafts) have been increasingly used as replacement material in the setting of infections. Bovine and equine pericardial patches are applied in particular as self-made tube grafts in the aortic region and also in infections of iliacofemoral prosthetic grafts and shunt infections.ResultsThe results of small clinical series on durability and resistance to reinfection are promising.ConclusionIt is feasible to use biosynthetic materials to replace infected intracavitary and extracavitary vascular grafts with remarkably low reinfection rates; however, the unique mechanical properties of the grafts as well as the initially increased thrombogenicity, need to be taken into consideration.
Highlights
Autologous veins are the optimal replacement material for an infected vascular graft in terms of handling, durability and resistance to reinfection
Lar grafts are highly resistant to infection when used in the elective setting; their use as replacement material for infected infrainguinal vascular grafts is only justified if autologous venous material is absent or insufficient and if good results have been seen in small application studies
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Summary
Xenogeneic grafts have found broad application in vascular surgery in the form of pericardial patches. Lar grafts are highly resistant to infection when used in the elective setting; their use as replacement material for infected infrainguinal vascular grafts is only justified if autologous venous material is absent or insufficient and if good results have been seen in small application studies. Their special mechanical properties require particular consideration, most notably in femorocrural applications. Initial experience with their use in intracavitary graft infections has been gained
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