Vol 11, No 1 (2005)
Research paper
Published online: 2005-01-14
Superficial femoral vein versus extra-anatomic bypass in treatment of vascular prosthesis infection
Acta Angiologica 2005;11(1):50-60.
Abstract
Background. The objective of this paper is to evaluate results of therapy of infected vascular prostheses with
replacement of the prosthetic material with autologous superficial femoral vein.
Material and methods. Between 2001 and 2003, 1580 vascular surgeries were performed in Department of Vascular Surgery. In 14 cases, indications of infection of the vascular prosthesis were seen. In 6 patients, venous material (superficial femoral vein — SFV) was used to re-establish circulation in the affected leg. SFV was used in the treatment of infections of aorto-bi-femoral bypasses (4 cases), aorto-femoral (1) and axillofemoral (1). In the last case, a desobliterated superficial artery was used (group I). In all the above cases, a new by-pass was run through the tunnel left after the removal of the infected prosthesis. In 8 cases, an extra-anatomical by-pass was inserted (group II). In 6 cases, axillo-bi-femoral by-pass was performed and 2 patients received axillo-popliteal bypasses. In every patient reconstructive procedure, regenerating flow in the affected limb, was preceded by partial or total excision of the infected prosthesis (during the same surgery).
Results.
None of the patients in whom we performed SFV harvest presented with major edema or venous insufficiency.
Conclusion. Treatment of vascular prosthesis infection is still a complicated therapeutic problem. Application of the correct treatment methods for each case is the key to therapeutic success. SVF may be an excellent replacement material, especially in cases where placement of an extra-anatomic bypass is impossible.
Material and methods. Between 2001 and 2003, 1580 vascular surgeries were performed in Department of Vascular Surgery. In 14 cases, indications of infection of the vascular prosthesis were seen. In 6 patients, venous material (superficial femoral vein — SFV) was used to re-establish circulation in the affected leg. SFV was used in the treatment of infections of aorto-bi-femoral bypasses (4 cases), aorto-femoral (1) and axillofemoral (1). In the last case, a desobliterated superficial artery was used (group I). In all the above cases, a new by-pass was run through the tunnel left after the removal of the infected prosthesis. In 8 cases, an extra-anatomical by-pass was inserted (group II). In 6 cases, axillo-bi-femoral by-pass was performed and 2 patients received axillo-popliteal bypasses. In every patient reconstructive procedure, regenerating flow in the affected limb, was preceded by partial or total excision of the infected prosthesis (during the same surgery).
Results.
| Group I (n = 6) | Group II (n = 8) | |
| Observation (months) | 4–18 (average 11,4) | 2–24 (average14,5) |
| Mortality | 1 (16,6%) | 2 (25%) |
| Amputations | 0 | 1 |
| Resurgeries | 2 | 1 |
None of the patients in whom we performed SFV harvest presented with major edema or venous insufficiency.
Conclusion. Treatment of vascular prosthesis infection is still a complicated therapeutic problem. Application of the correct treatment methods for each case is the key to therapeutic success. SVF may be an excellent replacement material, especially in cases where placement of an extra-anatomic bypass is impossible.
Keywords: blood vessel prosthesisbacterial infectioninfected aneurysmperipheral vascular disease