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Superficial femoral vein versus extra-anatomic bypass in treatment of vascular prosthesis infection
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Abstract
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.
Abstract
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 prosthesis; bacterial infection; infected aneurysm; peripheral vascular disease
About this articleTitle
Superficial femoral vein versus extra-anatomic bypass in treatment of vascular prosthesis infection
Journal
Issue
Article type
Research paper
Pages
50-60
Published online
2005-01-14
Page views
1093
Article views/downloads
2422
DOI
10.5603/aa.9900
Bibliographic record
Acta Angiologica 2005;11(1):50-60.
Keywords
blood vessel prosthesis
bacterial infection
infected aneurysm
peripheral vascular disease
Authors
Jacek Wojciechowski
Grzegorz Halena
Marcin Trenkner
Piotr Konefka
Łukasz Znaniecki
Czesław Kwiatkowski