Diagnosis and management of vascular graft infection: a report of 15 cases / 中国普通外科杂志

ABSTRACT

Objective To evaluate diagnostic procedures and clinical outcomes of vascular prosthetic and stent graft infection. Methods Clinical data of 15 cases suffering from vascular graft infection between 1985 and 2005 were retrospectively analyzed. Results The rate of vascular graft infection was 1. 14% among our series of 1316 cases of revascularizations. Vascular graft infection occurred within 4 months after graft implantation in 13 cases (86. 7% ). Graft infection developed after 4 months postoperatively in the other 2 cases ( 13. 3% ). Clinical manifestations included wound infection with vascular graft exposure, inguinal swelling or fistula, fever or sepsis, anastomotic hemorrhage, pulse loss of vascular graft or distal lower extremity and gangrene of distal lower extremity. Surgical treatment included en bloc removal of the infected graft and surrounding infected tissue, drainage and local irrigation with antibiotic solution, graft en bloc removal and primary amputation; Graft en bloc removal, drainage and revascularization with a saphenous vein or a new prosthetic graft; Aggressive debridement and local irrigation with antibiotic solution. Four patients died and the others recovered successfully. Conclusion The infection of a vascular graft is a rare complication in vascular surgery. Early diagnosis and aggressive surgical management can improve its prognosis.