Early complications of biologic extracellular matrix patch after use for femoral artery repair

• Published in: Journal of vascular surgery 2017-03, Vol.65 (3), p.705-710
• Main Authors: Dobrilovic, Nikola, MD, Soukas, Peter, MD, Sadiq, Immad, MD, Goldstein, Lisa, MD, Raman, Jaishankar, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Aneurysm, False - diagnostic imaging; Aneurysm, False - etiology; Animals; Biopsy; Endarterectomy - adverse effects; Endarterectomy - methods; Extracellular Matrix - transplantation; Female; Femoral Artery - diagnostic imaging; Femoral Artery - pathology; Femoral Artery - surgery; Heterografts; Humans; Intermittent Claudication - diagnostic imaging; Intermittent Claudication - surgery; Intestinal Mucosa - transplantation; Male; Middle Aged; Peripheral Arterial Disease - diagnostic imaging; Peripheral Arterial Disease - surgery; Retrospective Studies; Risk Factors; Severity of Illness Index; Surgery; Swine; Time Factors; Treatment Outcome; Ultrasonography, Doppler, Duplex
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2016.07.131

Abstract Background The CorMatrix (CorMatrix Cardiovascular, Roswell, Ga) biologic extracellular patch derived from porcine small intestinal mucosa provides a biologic scaffold for cellular ingrowth and eventual tissue regeneration. It has been used in a variety of applications, including cardiac and vascular repair procedures. Methods CorMatrix was used as a patch arterioplasty for femoral artery repair in conjunction with endarterectomy for seven separate procedures in six patients (one patient underwent staged, bilateral femoral procedures). Results Patients were a median age of 67 years (interquartile range, 3.6 years). Six of seven procedures (86%) were performed on male patients. There were no operative deaths. Three of seven procedures (43%) resulted in significant early complications. Two procedures (29%) resulted in catastrophic biologic extracellular matrix patch disruption (11 and 19 days after initial procedure), requiring emergency exploration, patch removal, and definitive repair with vein patch arterioplasty. Both patches demonstrated an absence of growth on culture. One procedure (14%) resulted in groin pseudoaneurysm formation. Use of the CorMatrix patch was suspended upon recognition of significant complications. Conclusions Use of CorMatrix patch in the femoral artery position demonstrates a high incidence of early postoperative complications, including catastrophic patch disruption and pseudoaneurysm formation.