Infection in Vascular Reconstructive Surgery
Authors:
M. Krejčí; Z. Gregor; J. Podlaha; Z. Kříž; P. Gladiš; M. Přívara; M. Dvořák; Z. Konečný
Authors‘ workplace:
II. chirurgická klinika LF MU a FN u sv. Anny v Brně, přednosta: doc. MUDr. Z. Gregor, CSc.
Published in:
Rozhl. Chir., 2007, roč. 86, č. 12, s. 629-634.
Category:
Monothematic special - Original
Overview
Purpose:
Infection is one of the most serious complications in vascular surgery.
Methods:
We summarize the patients operated on in our clinic during a 3-year period for infection of the arterial reconstruction.
Results:
577 primary arterial reconstructions were performed in the region of abdominal aorta and lower limb arteries during the years 2003–2005. In the same period 17 patients were operated on for infection of the arterial reconstruction grade III of Szilagyi (13x aortofemoral, 4x femoropopliteal region). The main agent of infection was Staphylococcus aureus (47.1%). In most cases the therapy involved revision of the infected groin (10x) with subsequent explantation of the reconstruction (7 patients). Eight extraanatomic reconstructions were performed. Three patients died during the follow-up (2 within 30 days of an operation). The one year mortality rate is 17.6%. Amputation was necessary in 6 patients (i.e. 35.3%)
Conclusions:
Handling vascular infection still remains a challenging diagnostic and therapeutic problem.
Key words:
infection – vascular surgery – prosthesis – sepsis
Sources
1. Calligaro, K. D., Veith, F. J., Yuan, J. G., et al. Intra-abdominal aortic graft infection: complete or partial graft preservation in patients at very high risk. J. Vasc. Surg., 2003, roč. 38, č. 6, s. 1199–1205.
2. Chang, J. K., Calligaro, K. D., Ryan, S., et al. Risk Factors Associated with Infection of Lower Extremity Revascularization: Analysis Of 365 Procedures Performed at a Teaching Hospital. Ann. Vasc. Surg., 2003, roč. 17, č. 1, s. 91–96.
3. Clagett, G. P., Bowers, B. L., Lopez-Viego, M. A., et al. Creation of a neo-aortoiliac system from lower extremity deep and superficial veins. Ann. Surg, 1993; roč. 218, s. 239–249.
4. Connoly, J. E., Price, T. Aortoiliac Endarterectomy: A Lost Art? Ann. Vasc. Surg., 2006, roč. 20, č. 1, s. 56–62.
5. Ducasse, E., Calisti, A., Speziale, F., et al. Aortoiliac Stent Graft Infection: Current Problems and Management. Ann. Vasc. Surg., 2004, roč. 18, č. 5, s. 521–526.
6. Dvořák, M., Jeřábek, J., Vlachovský, R., et al. Roboticky asistované laparoskopické cévní rekonstrukce – naše první zkušenosti. In: II. sjezd České společnosti kardiovaskulární chirurgie. Sborník abstrakt s programem. Brno, 2006.
7. Gabriel, M., Pukacki, F., Checinski, P., et al. Current options in prosthetic vascular graft infection: comparative analysis of 63 consecutive cases. Langenbecks Arch. Surg., 2004, roč. 389, s. 272–277.
8. Müller, B. T., Abbara, S., Hennes, N., Sandmann, W. Diagnostik und Therapie von sekundären aortointestinalen Fisteln Ergebnisse von 16 Patienten. Chirurg, 1999, roč. 70, č. 4, s. 415–421.
9. Podlaha, J., Leypold, J. Aorto-enterická píštěl. Rozhl. Chir., 2004, roč. 83, č. 10, s. 506–508.
10. Prager, M. R., Hoblaj, T., Nanobashvili, J., et al. Collagen- versus gelatine-coated Dacron versus stretch PTFE bifurcation grafts for aortoiliac occlusive disease: Long-term results of a prospective, randomized multicenter trial. Surgery, roč. 134, č. 1, s. 80–85.
11. Reid, J. D., MacDonald, P. S. Removing the infected aortofemoral graft using a two-stage procedure with a delay between the stages. Ann. Vasc. Surg., 2005, roč. 19, č. 6, s. 862–867.
12. Seeger, J. M., Back, M. R., Albright, J. L., et al. Influence of Patient Characteristics and Treatment Options on Outcome of Patients with Prosthetic Aortic Graft Infection. Ann. Vasc. Surg., 1999, roč. 13, č. 4, s. 413–420.
13. Seeger, J. M., Pretus, H. A., Welborn, M. B., et al. Long-term outcome after treatment of aortic graft infection with staged extra-anatomic bypass grafting and aortic graft removal. J. Vasc. Surg., 2000, roč. 32, č. 3, s. 451–459.
14. Štádler, P., Bělohlávek, O., Špaček, M., Michálek, P. Diagnosis of vascular prosthesis infection with FDG-PET/CT. J. Vasc. Surg., 2004 , roč. 40, č. 6, s. 1246–1247.
15. Szilagyi, E. D., Smith, R. F., Elliott, J. P., Vrandecic, M. P. Infection in Arterial Reconstruction with Synthetic Grafts. Ann. Surg., 1972, roč. 176, č. 3, s. 321–332.
16. Theis, F. J., Ferdinand, T., Hissen, W. Gefässersatz bei infiziertem aortobifemoralen Bypass – Composite-graft-Bypass aus v. saphena magna und kurzer Rifampicin-getrankter kollagen-beschichteter Y-Prothese. Gefasschirurgie, 2001, č. 1, s. 38–42.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2007 Issue 12
Most read in this issue
- Stapled Hemorrhoidopexy (Long method) – Procedure for Prolapsing Hemorrhoids (PPH) – Eight-Year Experience with the Method
- The Commonest Neuroendocrine GIT Tumors – Carcinoids
- Malignant Somatostatinoma (Brief Overview and a Case Review)
- Current Treatment Options of Osteoporotic Thoracolumbal Spinal Fractures