Peripheral Arterial Infections: Experience with Cryopreserved Allografts

Authors

• Michael Lee, Henry Ford HealthFollow
• Mouhammad Halabi, Henry Ford HealthFollow
• Alexander D. Shepard, Henry Ford HealthFollow
• Donald D. Chang, Henry Ford HealthFollow
• Hamzah Saleem, Henry Ford HealthFollow
• Loay S Kabbani, Henry Ford HealthFollow
• Mitchell R Weaver, Henry Ford HealthFollow
• Andi Peshkepija, Henry Ford HealthFollow
• Timothy Nypaver, Henry Ford HealthFollow
• Kevin Onofrey, Henry Ford HealthFollow
• Yasaman Kavousi, Henry Ford HealthFollow

Recommended Citation

Lee MY, Halabi M, Shepard A, Chang DD, Saleem H, Kabbani L, Weaver M, Peshkepija A, Nypaver T, Onofrey K, Kavousi Y. Peripheral Arterial Infections: Experience with Cryopreserved Allografts. Ann Vasc Surg. 2026.

Document Type

Article

Publication Date

9-25-2026

Publication Title

Annals of vascular surgery

Abstract

OBJECTIVES: To assess outcomes of peripheral arterial reconstruction using cryopreserved allograft (CPA) in infected or contaminated operative fields.

METHODS: A retrospective review was performed on patients who underwent peripheral arterial reconstruction using CPA in infected/contaminated fields at a quaternary medical center (2000-2025). CPA venous reconstruction, dialysis access, and bypass in non-infected and non-contaminated fields were excluded. Outcomes assessed included: overall survival, CPA-related complications (graft reinfection, stenosis/thrombosis, degeneration, dehiscence, rupture), limb loss, and CPA-related reinterventions.

RESULTS: Thirty-five patients (23 male) with median age of 67 years old in whom 38 CPAs were implanted were included. Indications for CPA use were: infected prosthetic graft (58%), infected bovine patch (21%), infected stent graft (8%), native arterial infections (8%), and vascular injuries in contaminated fields (5%). Vascular reconstructions involved the lower extremity in 87% of cases, the upper extremity in 11%, and the carotid artery in 3%. At a median follow-up of 34 months, CPA-related complications included stenosis / thrombosis (18%), reinfection (8%), rupture (3%), and anastomotic dehiscence (3%). Freedom from CPA-related complication was 74% at 1 year and 61% at 3 years. Prompt reintervention (n=11) resulted in an overall low amputation rate at 3 years (n=2). One-year and 3-year survival rates were both 77%, respectively.

CONCLUSIONS: CPA is a viable conduit option for peripheral arterial reconstruction in infected or contaminated fields. Occurrence of CPA-related complications underscores the need for careful surveillance and longitudinal follow-up. These data support the use of CPA as a viable conduit in complex cases where alternative options are limited, demonstrating favorable amputation-free survival, though with some need for reintervention.

PubMed ID

42790698

ePublication

ePub ahead of print