Journal of Vascular Surgery
Volume 50, Issue 4 , Pages 790-798 , October 2009

Prophylactic use of the silver-acetate–coated graft in arterial occlusive disease: A retrospective, comparative study

  • Axel Larena-Avellaneda, MD

      Affiliations

    • Department of Surgery I, University of Würzburg, Medical School, Würzburg, Germany
    • Department of Vascular Medicine, University Heart Center Hamburg, Hamburg, Germany
    • Corresponding Author InformationReprint requests: Axel Larena-Avellaneda, MD, Department of Surgery I, University of Würzburg, Medical School, Oberdürrbacher Str 6, 97080 Würzburg, Germany
  • ,
  • Sonja Russmann, MD

      Affiliations

    • Department of Surgery I, University of Würzburg, Medical School, Würzburg, Germany
  • ,
  • Martin Fein, MD

      Affiliations

    • Department of Surgery I, University of Würzburg, Medical School, Würzburg, Germany
  • ,
  • Eike Sebastian Debus, MD

      Affiliations

    • Department of Surgery I, University of Würzburg, Medical School, Würzburg, Germany
    • Department of Vascular Medicine, University Heart Center Hamburg, Hamburg, Germany

Received 20 October 2008 ,Accepted 4 May 2009.

  • Image Result

    Overall primary patency and limb salvage rates for the different indications (Kaplan-Meier). a, The patency rate for claudication is significantly better, while the curves for rest pain, tissue loss,

    Overall primary patency and limb salvage rates for the different indications (Kaplan-Meier). a, The patency rate for claudication is significantly better, while the curves for rest pain, tissue loss, and acute occlusion do not differ. b, In contrast, rest pain has a significantly better limb salvage rate compared to tissue loss and acute occlusion. Vertical dotted lines: 1 and 5 years.

  • Image Result
    Primary patency rates (Kaplan-Meier). a, Patency for the silver and nonsilver groups in patients with claudication (all operations). The control group seems superior. b, Subgroup analysis: patency rat

    Primary patency rates (Kaplan-Meier). a, Patency for the silver and nonsilver groups in patients with claudication (all operations). The control group seems superior. b, Subgroup analysis: patency rate for aorto-(bi-)femoral prostheses in claudicants, previous procedures on the vessel excluded. There is no difference between the groups. c, In femorodistal prosthesis implanted critical limb ischemia, the patency rates are similar. Statistic: log-rank test. Vertical dotted lines: 1 and 5 years.

  • Image Result
    Limb salvage rates for patients with limb at risk (Kaplan-Meier). a, Overall performance. Again, the results for the silver group were inferior to the nonsilver group. b, Subgroup analysis: aorto-(bi-

    Limb salvage rates for patients with limb at risk (Kaplan-Meier). a, Overall performance. Again, the results for the silver group were inferior to the nonsilver group. b, Subgroup analysis: aorto-(bi-)femoral prostheses; there is no difference between the groups. c, Femorocrural prostheses (without redo procedures) did not show a significant difference. Statistic: log-rank test. Dotted lines: 1 and 5 years.

  • Image Result
    Infection rates for different local conditions. a, Preceding procedure (angioplasty, thrombendarterectomy, or bypass in the groin). b, Existing bypass in the groin. c, Impaired wound healing. d, Revis

    Infection rates for different local conditions. a, Preceding procedure (angioplasty, thrombendarterectomy, or bypass in the groin). b, Existing bypass in the groin. c, Impaired wound healing. d, Revision for local complication. In all groups, silver did not prevent an infection when compared to the standard graft. Comparing the silver group with the control group in a-d, the differences were not statistically significant. Statistic: χ2 test.

 Competition of interest: none.

PII: S0741-5214(09)01008-8

doi: 10.1016/j.jvs.2009.05.003

Journal of Vascular Surgery
Volume 50, Issue 4 , Pages 790-798 , October 2009