David J Liesker, Barzi Gareb, Maarten J Speijers, Joost R VAN DER Vorst, Pieter B Salemans, Rudolf P Tutein Nolthenius, Clark J Zeebregts, Ben R Saleem
{"title":"Outcomes of Omniflow® II prosthesis used for revascularization in the femoral tract both in infected and non-infected setting.","authors":"David J Liesker, Barzi Gareb, Maarten J Speijers, Joost R VAN DER Vorst, Pieter B Salemans, Rudolf P Tutein Nolthenius, Clark J Zeebregts, Ben R Saleem","doi":"10.23736/S0021-9509.23.12692-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding the outcomes of Omniflow<sup>®</sup> II prosthesis in peripheral arterial revascularization at different anatomical sites and for different indications is scarce. Therefore, the aim of this study was to evaluate the outcomes of the Omniflow<sup>®</sup> II used at various positions within the femoral tract both in infected and non-infected setting.</p><p><strong>Methods: </strong>Patients who underwent reconstructive lower leg vascular surgery with implantation of an Omniflow<sup>®</sup> II from 2014 until 2021 at five medical centers were retrospectively included (N.=142). Patients were subdivided into the following categories: femoro-femoral crossover (N.=19), femoral interposition (N.=18), femoro-popliteal (above-the-knee [N.=25; AK] or below-the-knee [N.=47; BK]), and femoro-crural bypass grafts (N.=33). Primary outcome was primary patency and secondary outcomes included primary assisted patency, secondary patency, major amputation, vascular graft infection, and mortality. Outcomes were compared according to different subgroups and the surgical setting (infected versus non-infected).</p><p><strong>Results: </strong>The median follow-up was 35.0 (17.5-54.3) months. Three years primary patency of 58% was observed for femoro-femoral crossover bypass, 75% for femoral interposition graft, 44% for femoro-popliteal above-the-knee bypass, 42% for femoro-popliteal below-the-knee bypass, and 27% in the femoro-crural position (P=0.006). Freedom from major amputation at three years were 84% for femoro-femoral crossover bypass, 88% for femoral interposition bypass, 90% for femoro-popliteal AK bypass, 83% for femoro-popliteal BK bypass, and 50% for femoro-crural bypass (P<0.001).</p><p><strong>Conclusions: </strong>This study demonstrates the safety and feasibility of the use of Omniflow<sup>®</sup> II for femoro-femoral crossover-, femoral interposition-, and femoro-popliteal (AK and BK) bypass. Omniflow<sup>®</sup> II seems to be less suitable for femoro-crural bypass with a significantly lower patency compared to other positions.</p>","PeriodicalId":50245,"journal":{"name":"Journal of Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S0021-9509.23.12692-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Evidence regarding the outcomes of Omniflow® II prosthesis in peripheral arterial revascularization at different anatomical sites and for different indications is scarce. Therefore, the aim of this study was to evaluate the outcomes of the Omniflow® II used at various positions within the femoral tract both in infected and non-infected setting.
Methods: Patients who underwent reconstructive lower leg vascular surgery with implantation of an Omniflow® II from 2014 until 2021 at five medical centers were retrospectively included (N.=142). Patients were subdivided into the following categories: femoro-femoral crossover (N.=19), femoral interposition (N.=18), femoro-popliteal (above-the-knee [N.=25; AK] or below-the-knee [N.=47; BK]), and femoro-crural bypass grafts (N.=33). Primary outcome was primary patency and secondary outcomes included primary assisted patency, secondary patency, major amputation, vascular graft infection, and mortality. Outcomes were compared according to different subgroups and the surgical setting (infected versus non-infected).
Results: The median follow-up was 35.0 (17.5-54.3) months. Three years primary patency of 58% was observed for femoro-femoral crossover bypass, 75% for femoral interposition graft, 44% for femoro-popliteal above-the-knee bypass, 42% for femoro-popliteal below-the-knee bypass, and 27% in the femoro-crural position (P=0.006). Freedom from major amputation at three years were 84% for femoro-femoral crossover bypass, 88% for femoral interposition bypass, 90% for femoro-popliteal AK bypass, 83% for femoro-popliteal BK bypass, and 50% for femoro-crural bypass (P<0.001).
Conclusions: This study demonstrates the safety and feasibility of the use of Omniflow® II for femoro-femoral crossover-, femoral interposition-, and femoro-popliteal (AK and BK) bypass. Omniflow® II seems to be less suitable for femoro-crural bypass with a significantly lower patency compared to other positions.
背景:有关 Omniflow® II 假体在不同解剖部位和不同适应症的外周动脉血管再造术中的效果的证据很少。因此,本研究旨在评估 Omniflow® II 在感染和非感染情况下用于股骨道内不同位置的效果:回顾性纳入2014年至2021年期间在五家医疗中心接受小腿血管重建手术并植入Omniflow® II的患者(142人)。患者被细分为以下几类:股骨交叉(N.=19)、股骨插植(N.=18)、股骨-腘(膝上[N.=25;AK]或膝下[N.=47;BK])和股骨-硬膜旁路移植(N.=33)。主要结果为主要通畅率,次要结果包括主要辅助通畅率、次要通畅率、主要截肢率、血管移植感染率和死亡率。结果根据不同的亚组和手术环境(感染与非感染)进行比较:中位随访时间为 35.0(17.5-54.3)个月。股骨-股骨交叉旁路术的三年初次通畅率为58%,股骨穿插移植术为75%,股骨-膝上腘旁路术为44%,股骨-膝下腘旁路术为42%,股骨-胸壁位置为27%(P=0.006)。股骨-股骨交叉旁路术的三年内免大截肢率为84%,股骨间位旁路术为88%,股骨-腘动脉AK旁路术为90%,股骨-腘动脉BK旁路术为83%,股骨-硬膜外旁路术为50%:本研究证明了将 Omniflow® II 用于股-股骨交叉、股骨关节置换和股-腘(AK 和 BK)旁路的安全性和可行性。与其他位置相比,Omniflow® II 似乎不太适合股骨干旁路,其通畅率明显较低。
期刊介绍:
The Journal of Cardiovascular Surgery publishes scientific papers on cardiac, thoracic and vascular surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, therapeutical notes, special articles and letters to the Editor.
Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (www.icmje.org). Articles not conforming to international standards will not be considered for acceptance.