Vol 10, No 4 (2004)
Research paper
Published online: 2004-11-23
Autologus superficial femoral vein reconstruction in vascular prosthetic graft infections in aorto-femoral position — own experience
Acta Angiologica 2004;10(4):189-196.
Abstract
Background. The aim of the study was to respectively analyze our experience
in the use of superficial femoral vein (SFV) as arterial conduit in patients with
infection of the vascular prosthetic graft in the aortofemoral position.
Material and methods. Between 1998–2004 at Department of General and Vascular Surgery, L. Rydgier Medical University, Bydgoszcz, in 19 patients we replaced infected prosthetic graft in the aorto-femoral position with autogenous SFV. Eighteen men and 1 female entered the group at age 51–75 years (mean age 59.6 years). The mean interval between original intervention and clinical manifestation of infection was 3.34 years (SD ± 3.3 years). Multiple vascular procedures were performed in 9 patients (47%). Obtained microbial tests indicated meticilin resistant Staphylococci as dominating pathogen (63.2%). Following excision of infected grafts, bilateral reconstructions were conducted in 11 cases, the remaining 8 patients received unilateral graft.
Results. Seven individuals died during hospitalization (37%). Five of these were attributable to surgical complications, the other 2 were cardiac-related. Among survivals, above the knee amputation was performed in 5 cases (26.3%). Completely satisfactory effects of the treatment were achieved in 7 patients (58.3%). Ischemic stroke occurred in 1 patient.
Conclusions. Treatment of infected vascular prosthetic graft still carries a substantial risk of death and limb loss in the perioperative period. Use of autologus superficial femoral veins remains one of the therapeutic options in treatment of infected vascular prosthesis in the aorto-femoral.
Material and methods. Between 1998–2004 at Department of General and Vascular Surgery, L. Rydgier Medical University, Bydgoszcz, in 19 patients we replaced infected prosthetic graft in the aorto-femoral position with autogenous SFV. Eighteen men and 1 female entered the group at age 51–75 years (mean age 59.6 years). The mean interval between original intervention and clinical manifestation of infection was 3.34 years (SD ± 3.3 years). Multiple vascular procedures were performed in 9 patients (47%). Obtained microbial tests indicated meticilin resistant Staphylococci as dominating pathogen (63.2%). Following excision of infected grafts, bilateral reconstructions were conducted in 11 cases, the remaining 8 patients received unilateral graft.
Results. Seven individuals died during hospitalization (37%). Five of these were attributable to surgical complications, the other 2 were cardiac-related. Among survivals, above the knee amputation was performed in 5 cases (26.3%). Completely satisfactory effects of the treatment were achieved in 7 patients (58.3%). Ischemic stroke occurred in 1 patient.
Conclusions. Treatment of infected vascular prosthetic graft still carries a substantial risk of death and limb loss in the perioperative period. Use of autologus superficial femoral veins remains one of the therapeutic options in treatment of infected vascular prosthesis in the aorto-femoral.
Keywords: vascular surgerysurgical complicationsinfection