Long-Term Outcomes of Omniflow II and BioIntegral Xenografts for Open Aortic Reconstruction in Predominantly Infected Settings: A Multicenter Cohort Study.

objectiveEvidence surrounding conduit selection for open in situ aortic reconstruction remains limited particularly for xenograft use in infected settings. We evaluated long-term outcomes after open aortic and aorto-iliac reconstruction using BioIntegral No-React bovine grafts and Omniflow II biosynthetic grafts in patients unsuitable for autologous vein reconstruction.

methodsThis multicenter cohort study combined a retrospective Omniflow II cohort from six Dutch hospitals with a prospectively collected BioIntegral registry. Patients undergoing open aortic, aortoiliac, or aortofemoral reconstruction in infected and selected noninfected settings between 2014 and 2021 were included; peripheral bypasses and arteriovenous access procedures were excluded. The primary outcome was graft infection. Secondary outcomes included patency rates (primary, primary-assisted, and secondary), mortality, freedom from major amputation, and 30-day adverse events. Time-to-event outcomes were analyzed using Kaplan-Meier methods and univariate Cox regression.

resultsForty-four patients were included (BioIntegral n = 21, Omniflow II n = 23). Baseline characteristics were comparable except for a lower body mass index in the Omniflow group (26.8 vs. 23.9 kg/m

conclusionsIn open aortic reconstruction performed predominantly for vascular graft or endograft infection, BioIntegral and Omniflow II xenografts showed comparable long-term outcomes without statistically significant differences in patency, mortality or freedom from major amputation. Findings should be interpreted as descriptive given the small sample size and mixed indications. Late graft infections highlight the need for prolonged surveillance after reconstruction.