Treatment of Prosthetic Vascular Graft Infections Using Cryopreserved Homografts: A Surgical Case Series.

Infections of vascular prostheses remain a formidable challenge in vascular surgery due to their high morbidity and mortality rates. This retrospective study presents the clinical experience of using vascular homografts in four complex cases of infected synthetic vascular prostheses treated between 2015 and 2020. Patients presented with varied complications, including duodeno-paraprosthetic fistula, aneurysmal degeneration, thromboembolism, and infection following aorto-bifemoral and iliofemoral bypasses, as well as stent-graft infections. In all but one case, homograft reconstruction led to favorable outcomes, with long-term follow-up confirming graft patency and absence of reinfection. One patient succumbed to sepsis and multiorgan failure postoperatively. The use of cryopreserved homografts demonstrated efficacy and safety, particularly in cases unsuitable for synthetic or autologous grafts. Our findings highlight the potential of vascular homografts as a valuable alternative in managing prosthetic graft infections, emphasizing the importance of individualized treatment approaches, multidisciplinary planning, and advanced surgical techniques.