Rifampicin-soaked versus bovine prostheses in the management of aortic graft infections: a retrospective single-center cohort study.
- 1Department of Vascular and Endovascular Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. [email protected].
- 2Department of Vascular and Endovascular Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Abstract
Background
Aortic vascular graft and endograft infections (aortic VGEI) remain a rare but life-threatening complication following aortic reconstruction. This retrospective study compares outcomes between bovine pericardial graft prostheses and rifampicin-soaked Dacron grafts.Methods
In this retrospective single-center cohort study, we analyzed 62 patients between January 2018 and December 2025 for aortic vascular graft or endograft infection requiring graft explantation and in-situ reconstruction. Patients received either a bovine pericardial graft (n=21) or a rifampicin-soaked Dacron prosthesis (n=41). Survival, treatment failure, perioperative variables, and microbiology were analyzed.Results
Patients in the bovine and rifampicin groups were comparable in terms of age (72.57 vs. 73.58 years, p = 0.685) and sex distribution (85.71% vs. 73.17% male, p = 0.346). BMI, preoperative dialysis, and aortic clamping time were higher in the bovine group. Four treatment failures, defined as persistent or recurrent infection of the reconstructed aortic segment, occurred during follow-up; all were observed after reconstruction with rifampicin-soaked Dacron (4/41, 9.8%), whereas no treatment failure occurred in the bovine pericardial group (0/21). In-hospital mortality was comparable between groups (n=3:14.3% vs. n=8: 19.5%, p = 0.735). Kaplan-Meier analysis demonstrated no significant difference in survival (p = 0.256) or treatment failure rate (p = 0.833). Candida spp. were the most frequent pathogens (27.8%) and significantly associated with secondary aorto-enteric fistula (p=0.003).Conclusion
Survival and treatment failure rates were comparable, with a trend toward fewer infection-related complications after bovine pericardial grafting. Despite use in more complex cases, bovine grafts may represent a promising biological alternative.
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BibTeX
@article{strzoda2026rifampicinsoaked,
title = {{Rifampicin-soaked versus bovine prostheses in the management of aortic graft infections: a retrospective single-center cohort study.}},
author = {Viktoria Weronika Strzoda and Miroslav Dimitrov Yordanov and Alexander Oberhuber and Abdulhakim Ibrahim},
journal = {Langenbeck's archives of surgery},
year = {2026},
month = oct,
doi = {10.1007/s00423-026-04349-z},
url = {https://europepmc.org/article/MED/42925319},
note = {CC BY},
}
RIS
TY - JOUR
TI - Rifampicin-soaked versus bovine prostheses in the management of aortic graft infections: a retrospective single-center cohort study.
AU - Viktoria Weronika Strzoda
AU - Miroslav Dimitrov Yordanov
AU - Alexander Oberhuber
AU - Abdulhakim Ibrahim
PY - 2026
DA - 2026/10/23
JO - Langenbeck's archives of surgery
DO - 10.1007/s00423-026-04349-z
UR - https://europepmc.org/article/MED/42925319
AB - Background Aortic vascular graft and endograft infections (aortic VGEI) remain a rare but life-threatening complication following aortic reconstruction. This retrospective study compares outcomes between bovine pericardial graft prostheses and rifampicin-soaked Dacron grafts.Methods In this retrospective single-center cohort study, we analyzed 62 patients between January 2018 and December 2025 for aortic vascular graft or endograft infection requiring graft explantation and in-situ reconstruction. Patients received either a bovine pericardial graft (n=21) or a rifampicin-soaked Dacron prosthesis (n=41). Survival, treatment failure, perioperative variables, and microbiology were analyzed.Results Patients in the bovine and rifampicin groups were comparable in terms of age (72.57 vs. 73.58 years, p = 0.685) and sex distribution (85.71% vs. 73.17% male, p = 0.346). BMI, preoperative dialysis, and aortic clamping time were higher in the bovine group. Four treatment failures, defined as persistent or recurrent infection of the reconstructed aortic segment, occurred during follow-up; all were observed after reconstruction with rifampicin-soaked Dacron (4/41, 9.8%), whereas no treatment failure occurred in the bovine pericardial group (0/21). In-hospital mortality was comparable between groups (n=3:14.3% vs. n=8: 19.5%, p = 0.735). Kaplan-Meier analysis demonstrated no significant difference in survival (p = 0.256) or treatment failure rate (p = 0.833). Candida spp. were the most frequent pathogens (27.8%) and significantly associated with secondary aorto-enteric fistula (p=0.003).Conclusion Survival and treatment failure rates were comparable, with a trend toward fewer infection-related complications after bovine pericardial grafting. Despite use in more complex cases, bovine grafts may represent a promising biological alternative.
SN - 1435-2443
SN - 1435-2451
ER -