Background and Aims: Managing infrainguinal vascular graft infections (VGI) in bypass
reconstruction is complex. Although an autologous vein is the preferred graft material, alternative
conduits are required when autologous veins are unavailable. This study aimed to compare the
efficacy of cryopreserved arterial homografts and biosynthetic glutaraldehydemodified
ovine collagen grafts (Omniflow II) for the treatment of infrainguinal VGI.
Methods: The study was retrospective across two centers and included patients with infrainguinal
VGI treated with cryopreserved arterial homografts or Omniflow II grafts between 2009 and 2019.
Freedom from reinfection, primary patency rates, amputation-free survival, and overall survival
were analyzed using 5-year Kaplan-Meier estimates.
Results: Overall, 63 patients with infrainguinal VGI were treated with either Omniflow II grafts
(n = 34) or cryopreserved arterial homografts (n = 29). At 5 years, freedom from reinfection was
97.1% for Omniflow II grafts and 93.1% for cryopreserved arterial homografts (p = .4). Primary
patency was 50% for Omniflow II grafts and 55.2% for the cryopreserved arterial homografts
(p = .5). Amputation-free survival was 52.9% for Omniflow II grafts and 55.2% for cryopreserved
arterial homografts (p = .7). No graft degeneration or graft ruptures were observed during the
follow-up.
Conclusions: This study suggests that biosynthetic grafts are viable and accessible alternatives
for traditional graft materials, offering similar efficacy and ease of use. Although autologous
vein grafts remain the gold standard for VGI management, biosynthetic grafts may serve as
a viable alternatives to cryopreserved arterial homografts in the treatment of infrainguinal
VGIs.