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Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection

Background: This study aimed to present cases with cryopreserved human allografts (CHAs) for vascular reconstruction in both aortic and peripheral infected prosthetic grafts. Materials and Methods: This is a single center, observational descriptive study with retrospective analysis. In all cases, th...

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Autores principales: Bossi, Matteo, Tozzi, Matteo, Franchin, Marco, Ferraro, Stefania, Rivolta, Nicola, Ferrario, Massimo, Guttadauro, Chiara, Castelli, Patrizio, Piffaretti, Gabriele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835436/
https://www.ncbi.nlm.nih.gov/pubmed/29515701
http://dx.doi.org/10.3400/avd.oa.17-00068
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author Bossi, Matteo
Tozzi, Matteo
Franchin, Marco
Ferraro, Stefania
Rivolta, Nicola
Ferrario, Massimo
Guttadauro, Chiara
Castelli, Patrizio
Piffaretti, Gabriele
author_facet Bossi, Matteo
Tozzi, Matteo
Franchin, Marco
Ferraro, Stefania
Rivolta, Nicola
Ferrario, Massimo
Guttadauro, Chiara
Castelli, Patrizio
Piffaretti, Gabriele
author_sort Bossi, Matteo
collection PubMed
description Background: This study aimed to present cases with cryopreserved human allografts (CHAs) for vascular reconstruction in both aortic and peripheral infected prosthetic grafts. Materials and Methods: This is a single center, observational descriptive study with retrospective analysis. In all cases, the infected prosthetic graft material was completely removed. At discharge, patients were administered anticoagulants. Follow-up examinations included clinical visits, echo-color-Doppler ultrasounds, or computed tomography angiography within 30 days and at 3, 6, and 12 months after the treatment, and then twice per year. Results: We treated 21 patients (90% men, n=19) with the mean age of 71±12 years and mean interval between the initial operation and replacement with CHA of 30 months [range, 1–216; interquartile range (IQR), 2–36]. In-hospital mortality was 14% (n=3); no CHA-related complication led to death. Limb salvage was 100%. No patient was lost at the median follow-up of 14 months (range, 2–61; IQR, 6–39). No rupture, aneurysmal degeneration, or re-infection occurred. Estimated freedom from CHA-related adverse events (95% confidence interval, 43–63) was 95% at 3 years. Conclusion: In our experience, CHAs are a viable option for prosthetic graft infections and provide satisfactory clinical results and favorable stability because of a very low rate of CHA-related adverse events during follow-up.
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spelling pubmed-58354362018-03-07 Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection Bossi, Matteo Tozzi, Matteo Franchin, Marco Ferraro, Stefania Rivolta, Nicola Ferrario, Massimo Guttadauro, Chiara Castelli, Patrizio Piffaretti, Gabriele Ann Vasc Dis Original Article Background: This study aimed to present cases with cryopreserved human allografts (CHAs) for vascular reconstruction in both aortic and peripheral infected prosthetic grafts. Materials and Methods: This is a single center, observational descriptive study with retrospective analysis. In all cases, the infected prosthetic graft material was completely removed. At discharge, patients were administered anticoagulants. Follow-up examinations included clinical visits, echo-color-Doppler ultrasounds, or computed tomography angiography within 30 days and at 3, 6, and 12 months after the treatment, and then twice per year. Results: We treated 21 patients (90% men, n=19) with the mean age of 71±12 years and mean interval between the initial operation and replacement with CHA of 30 months [range, 1–216; interquartile range (IQR), 2–36]. In-hospital mortality was 14% (n=3); no CHA-related complication led to death. Limb salvage was 100%. No patient was lost at the median follow-up of 14 months (range, 2–61; IQR, 6–39). No rupture, aneurysmal degeneration, or re-infection occurred. Estimated freedom from CHA-related adverse events (95% confidence interval, 43–63) was 95% at 3 years. Conclusion: In our experience, CHAs are a viable option for prosthetic graft infections and provide satisfactory clinical results and favorable stability because of a very low rate of CHA-related adverse events during follow-up. Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology 2017-12-25 /pmc/articles/PMC5835436/ /pubmed/29515701 http://dx.doi.org/10.3400/avd.oa.17-00068 Text en Copyright © 2017 Annals of Vascular Diseases http://creativecommons.org/licenses/by-nc-sa/4.0/ This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original.
spellingShingle Original Article
Bossi, Matteo
Tozzi, Matteo
Franchin, Marco
Ferraro, Stefania
Rivolta, Nicola
Ferrario, Massimo
Guttadauro, Chiara
Castelli, Patrizio
Piffaretti, Gabriele
Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection
title Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection
title_full Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection
title_fullStr Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection
title_full_unstemmed Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection
title_short Cryopreserved Human Allografts for the Reconstruction of Aortic and Peripheral Prosthetic Graft Infection
title_sort cryopreserved human allografts for the reconstruction of aortic and peripheral prosthetic graft infection
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835436/
https://www.ncbi.nlm.nih.gov/pubmed/29515701
http://dx.doi.org/10.3400/avd.oa.17-00068
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