Vascular reconstructions infections in the aortofemoral region
Authors:
V. Třeška; B. Čertík; J. Moláček; K. Houdek; M. Čechura; R. Šulc; J. Fichtl; J. Doležal; M. Polák
Authors‘ workplace:
Chirurgická klinika FN a LFUK v Plzni, přednosta: Prof. MUDr. V. Třeška, DrSc.
Published in:
Rozhl. Chir., 2012, roč. 91, č. 11, s. 597-600.
Category:
Original articles
Overview
Introduction:
The incidence of prosthetic vascular graft infections in the aortofemoral region is reported at 0.6–3%. These complications are burdened with a high mortality of up to 50% and an amputation rate of up to 20%. The aim of our study was to give a complex view on the diagnostic and treatment possibilities of these serious complications of reconstructive vascular surgery.
Material and methods:
Prosthetic bypass grafts were performed in 1088 patients in the aortofemoral region between 2001–2011 at the Department of Surgery, Teaching Hospital and the Faculty of Medicine, Charles University, in Pilsen. 24 (2.2%) patients suffered from graft infection at various time intervals after primary vascular reconstruction. Clinical examination, computed tomography and positron emission tomography were the main diagnostic methods of vascular graft infection. “In situ” reconstructions dominated over extra-anatomic reconstructions. When the infection involved only the peripheral part of the prosthetic graft, a more conservative approach – local debridement and drainage – was used.
Results:
The mortality of the patients was 20.8%, high amputation rate 12.5%, and morbidity rate 58.3%, respectively. The average time of hospitalization in surviving patients was 46.5 days. Primary 30-day patency rate in “in situ” and extra-anatomic reconstructions was 100 and 60%, respectively.
Conclusion:
Prosthetic vascular graft infections in the aortofemoral region require tailored multidisciplinary treatment approach in vascular centres. “In situ” reconstructions are the method of first choice. A more conservative approach in infections involving only the peripheral part of the vascular reconstruction has a positive treatment effect.
Key words:
vascular reconstructions – aortofemoral region – infections – diagnosis – treatment
Sources
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
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