Objectives. The purpose of this study is to evaluate the use of allogenic material in the treatment of prosthetic graft infections in the aorto-ilio-femoral segment. Material and Methods. In this paper 39 cases of the massive aorto-ilio-femoral graft infection treated by the replacement of infected prosthesis with arterial homograft are presented. The arterial allograft was stored with application of cold ischemia method in preservation solution at +4°C (29 patients) and with cryopreservation (4 patients. The Duplex-Doppler Ultrasound and the scintigraphy with use of Technetium-labeled leukocytes were used in the diagnostic evaluation of infection and of the healing process of the homograft. During the follow-up period the 29 patients with the usage of fresh homograft were divided into two groups: group I received immunosuppressive regimen after surgery (16 patients) and group II without immunosuppression (13 patients). In the group III we observed 4 patients with the usage of cryopreserved homograft. In addition were operated 4 patients with aorto-duodenal fistula and 2 patients with local infection of vascular prosthesis. In these cases fresh homograft was used. Results. In the group I no complications due to the homograft's wall degradation (e.g. graft rupture) were noticed. In the group II there complications related to the impairment of the allograft wall were observed: in 3 cases - the graft rupture, in 2 cases - the true graft aneurysm and homograft thrombosis in 3 cases. In all cases in the group III with the usage of cryopreserved homograft aneurysms were observed. In all groups the regression of infection after in situ replacement of the synthetic prosthesis with homograft was monitored with the scintigraphy examination. Conclusion. The use of arterial homograft with application of cold ischemia method and with immunosuppression in the therapy of prosthetic graft infection is a proper treatment method.
|Translated title of the contribution||The use of allogenic vascular transplants in the treatment of prosthetic infections in relationship of the storage of allograft and immunosuppression|
|Number of pages||8|
|Journal||Advances in Clinical and Experimental Medicine|
|Publication status||Published - 2003|