Management of Patients with Prosthetic Vascular Graft Infection

Seeger, James M.
February 2000
American Surgeon;Feb2000, Vol. 66 Issue 2, p166
Academic Journal
Management of patients with infected prosthetic vascular grafts is one of the most difficult challenges faced by the vascular surgeon. Patients often present with nonspecific symptoms, but delay in treatment can lead to life-threatening sepsis and/or hemorrhage. Fortunately, prosthetic vascular graft infection is uncommon, with the incidence varying between 1 and 6 per cent, depending on the location of the graft. Initially, the potentially infected vascular graft should be imaged using either CT or magnetic resonance imaging, with radionuclide studies being reserved for those instances in which imaging studies do not confirm or exclude the diagnosis of infection. Current treatments for prosthetic vascular graft infection include attempted graft preservation, graft removal with in situ graft replacement (using autogenous or new prosthetic grafts), and graft removal with extra-anatomic bypass. Morbidity and mortality associated with treatment, likelihood of long-term limb salvage, and likelihood of persistent or recurrent infection vary among these types of treatment. Therefore, in an individual patient with a prosthetic vascular graft infection, many things must be considered to appropriately determine the treatment most likely to achieve eradication of the infection and long-term limb salvage with the lowest risk. Regardless, with appropriate application of the techniques currently available for treatment of prosthetic vascular graft infection, long-term elimination of infection and limb preservation can be achieved in the great majority of patients with this grave problem.


Related Articles

  • Vascular Graft Infection with Candida Albicans: Case Report. Weber, Frederick H.; Wilson, Mary E. // Vascular Surgery;May/Jun1986, Vol. 20 Issue 3, p204 

    This paper reports a patient with a pure Candida albicans vascular graft infection. Presentation was notable for the absence of systemic signs and symptoms of infection, minimal local tissue reaction, and a paucity of organisms in the initial pathologic specimen. The clinical course with...

  • ANTIBIOTICS AND ENDOCARDITIS. Meyer, G. // American Journal of Gastroenterology;Jun1994, Vol. 89 Issue 6, p825 

    Discusses the use of antibiotics by gastroenterologists for the prevention of endocarditis. Factor that could increase risk for infections in gastroenterology procedures; Role of amoxicillin in upper prophylaxis; Stance of gastroenterology experts on the indication for prophylactic antibiotic...

  • Which prosthesis is more resistant to vascular graft infection: polytetrafluoroethylene or Omniflow II biosynthetic grafts? Bozoglan, Orhan; Mese, Bulent; Eroglu, Erdinc; Elveren, Serdal; Gul, Mustafa; Celik, Ahmet; Yildirimdemir, Halil; Ciralik, Harun; Yasim, Alptekin // Surgery Today;Mar2016, Vol. 46 Issue 3, p363 

    Purpose: The aim of this study was to determine whether polytetrafluoroethylene grafts or Omniflow II biosynthetic grafts are more resistant to infection caused by Staphylococcus aureus. Methods: Sixty rats were divided into six groups. In Groups 1A, 1B and 1C, a polytetrafluoroethylene graft...

  • Mycobacterium chimaera infections in post-operative patients exposed to heater-cooler devices: An overview. Ogunremi, T.; Taylor, G.; Johnston, L.; Amaratunga, K.; Muller, M.; Coady, A.; Defalco, K.; Dunn, K.; Johnstone, J.; Smith, S.; Embree, J.; Henry, B.; Stafford, J. // Canada Communicable Disease Report;May2017, Vol. 43 Issue 5, p107 

    A multi-country outbreak of Mycobacterium chimaera infection associated with contaminated heater-cooler devices (HCDs) has been reported, with more than 70 cases in Europe and the United States and two cases in Canada to date. The epidemiological and microbiological characteristics of this...

  • Femoro-Distal Posterior Tibial Bypass -- Management of Infected Vein Graft. Popovsky, Julio; Fleegler, Earl; Grossman, Morton // Vascular Surgery;Mar/Apr1977, Vol. 11 Issue 2, p103 

    A case of local necrosis and infection of the skin overlying a femoro-to-posterior tibial artery saphenous vein bypass graft in a patient with pregangrenous symptoms is described. A method of circumvating this area with a new vein graft to isolate the exposed portion and re-establish vascular...

  • Surgical Treatment of Infected Aortofemoral Grafts: A Fifteen-Year Experience. Di Marzo, Luca; Feldhaus, Richard J.; Schultz, Richard D. // Vascular Surgery;Jul/Aug1987, Vol. 21 Issue 4, p229 

    During the last fifteen years, we performed a total of 855 aortofemoral reconstructions. Fifteen (1.75%) grafts were surgically removed (completely or partially) owing to a severe infection (Szilagyi: Grade 3) at a mean of 66.3 months (SD < 37.9) after their implantation. Diagnosis was always...

  • Prosthetic Vascular Conduit in Contaminated Fields: A New Technology to Decrease ePTFE Infections. Fischer, Peter E.; Fabian, Timothy C.; Derijk, Waldemar G.; Edwards, Norma M.; Decuypere, Michael; Landis, Ryan M.; Barnard, Danielle L.; Magnotti, Louis J.; Croce, Martin A. // American Surgeon;Jun2008, Vol. 74 Issue 6, p524 

    Vascular reconstruction using prosthetic materials in contaminated fields can lead to infection, graft loss, and subsequent amputation. We hypothesized that minocycline and rifampin bound to an ePTFE graft using a unique methacrylate technology would provide for resistance from infection and...

  • Editorial Comment: Re: Cryopreserved human allografts (homografts) for the management of graft infections in the ascending aortic position extending to the arch. Carrel, Thierry; Czerny, Martin; Schmidli, Jürg // European Journal of Cardio-Thoracic Surgery;Jun2013, Vol. 43 Issue 6, p1175 

    The article comments on a study published within the issue which investigated the benefits of self-constructed xenopericardial vascular grafts for the management of graft infections in the ascending aortic position extending to the arch. Findings showed that xenopericardial vascular grafts are...

  • Duplex scan graft surveillance: How often and in whom? Hill, Stephen L. // American Surgeon;Jun1995, Vol. 61 Issue 6, p507 

    Determines a surveillance protocol that is cost-effective and accurate in detecting both high-risk, early failing grafts and following long-term grafts. Grafts with normal velocities and long-term graft patency; Grafts which occluded shortly after the scans for no apparent reason.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics