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Home > Journals > Italian Journal of Vascular and Endovascular Surgery > Past Issues > Giornale Italiano di Chirurgia Vascolare 2003 December;10(4) > Giornale Italiano di Chirurgia Vascolare 2003 December;10(4):333-46



A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus

Frequency: Quarterly

ISSN 1824-4777

Online ISSN 1827-1847


Giornale Italiano di Chirurgia Vascolare 2003 December;10(4):333-46


Arterial allograft reconstruction in infected vascular prosthetic grafts. Review of our series in the light of a compatibility study

Odero A. 1, Pirrelli S. 1, Arici V. 1, Piccolo G. 2, Guarino A. 3, Klersy C. 4

1 Vas­cular Sur­gery ­Chair. Uni­ver­sity of ­Pavia IRCCS San ­Matteo Poly­clinic, ­Pavia, Italy
2 North ­Italian Trans­plant, ­Milan Poly­clinic, ­Milan, Italy
3 Italian Allo­graft ­Bank Mon­zino Car­di­ology ­Centre, ­Milan, Italy
4 Bio­met­rics and Clin­ical Epi­dem­i­ology Ser­vice IRCCS San ­Matteo Poly­clinic, ­Pavia, Italy

Back­ground. The use of arte­rial allo­graft is now a wide­spread ther­a­peutic alter­na­tive in ­infected vas­cular pros­thetic ­grafts and ­mycotic aneu­rysms. Our ­series is ana­lysed in func­tion of ­some fac­tors pos­sibly ­linked to the devel­op­ment of allo­graft-cor­re­lated com­pli­ca­tions.
­Methods. ­Between ­December 1994 and ­March 2002, 23 ­patients ­with ­infected vas­cular pros­thetic ­graft ­were ­treated at the Vas­cular Sur­gery ­Clinic, Uni­ver­sity of ­Pavia, ­IRCCS San Matteo Poly­clinic. The ­patients ­were sub­jected to sur­gical ­removal of the ­infected pros­thetic ­graft and in ­situ revas­cu­lar­isa­tion ­through homol­o­gous arte­rial ­graft. ­Mean ­follow-up was 27.2 ­month (­range 40 ­days-77.4 ­months).
­Results. In 2 ­cases it was impos­sible to ­implant the allo­graft: 1 for intra­op­er­a­tive ­decease of the ­patient, 1 for intra­op­er­a­tive rup­ture of the allo­graft. ­Overall mor­tality was 34.7%; the ampu­ta­tion ­rate was 13%. In 34.6% of ­cases no micro­or­ganism was iso­lated on cul­turing the ­explanted pros­thetic ­graft. The ­rate of per­i­op­er­a­tive allo­graft-cor­re­lated com­pli­ca­tions was 30.5%, ­with ­mean ­onset at 6 ­days. The ­rate of ­late allo­graft-cor­re­lated com­pli­ca­tions was 39%, ­with ­mean ­onset at 25.9 ­months. No sig­nif­i­cant asso­ci­a­tion was ­found ­between AB0 com­pat­ibility and devel­op­ment of allo­graft-cor­re­lated com­pli­ca­tions. A sig­nif­i­cant asso­ci­a­tion was ­detected ­between ­lower ­risk of devel­oping ­early com­pli­ca­tions and age of ­donor ­above 40 ­years.
Con­clu­sions. ­Among fac­tors influ­encing the devel­op­ment of allo­graft-cor­re­lated com­pli­ca­tions, age of ­donor ­below 40 ­years and his­tory of ­drug aller­gies ­were ­found to be asso­ciated ­with a ­higher ­risk of allo­graft-cor­re­lated com­pli­ca­tions.

language: English, Italian


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