Blood vessel reconstruction infections: a practical view

Česká verzia

Authors: M. Krejčí; Z. Gregor; Z. Kříž; J. Podlaha; Z. Konečný; M. Dvořák
Authors place of work: II. chirurgická klinika Lékařské fakulty MU a FN u sv. Anny Brno, přednosta doc. MUDr. Zdeněk Gregor, CSc.
Published in the journal: Vnitř Lék 2008; 54(2): 178-182
Category: Review

Summary

Infection represents a serious complication in vascular surgery. The average of 2-3 % of reconstructions are involved. The article offers a review of current diagnosis and treatment of infection after vascular reconstruction. Emphasis is put on early diagnosis and its impact on prognosis of patients. We summarize the practical potential of surgical treatment. The situation is illustrated by our results from the years 2004-2006. During the last 3 years 19 patients were operated on for infection of the arterial reconstruction (15ways aorto-femoral and 4ways femoro-popliteal bypass). The main agent was Staphylococcus aureus (9 patients, i.e. 47.4 %). In most cases explantation of the whole infected reconstruction was performed (13 patients). The early mortality rate is 26.3 %. Amputation was necessary in 6 patients (i.e. 31.5 %). Our results are fully comparable to those from other centres of vascular surgery.

Key words:
infection - vascular prosthesis - reconstruction - sepsis

Zdroje

1. Castier Y, Francis F, Cerceau P et al. Cryopreserved arterial allograft reconstruction for peripheral graft infection. J Vasc Surg 2005; 41: 30-37.

2. Clagett GP, Bowers BL, Lopez-Viego MA et al. Creation of a neo-aortoiliac system from lower extremity deep and superficial veins. Ann Surg 1993; 218: 239-249.

3. De la Cueva L, Plancha MC, Reyes MD et al. Vascular Graft Thrombózes: 99mTc-HMPAO Leukocyte Scintigraphy False Positive Result in Diagnosis of Infection. EJVES Extra 2005; 9: 82-83.

4. Edelman ER. Vascular tissue engineering: designer arteries. Circ Res 1999; 85: 1115-1117.

5. Firt P, Hejnal J, Vaněk I. Cévní chirurgie. 2. ed. Praha: Karolinum 2006.

6. Franke S, Voit R. The Superficial Femoral Vein as Arterial Substitute in Infections of the Aortoiliac Region. Ann Vasc Surg 1997; 11: 406-412.

7. Gordon LL, Hagino RT, Jackson MR et al. Complex Aortofemoral Prosthetic Infection. The Role of Autogenous Superficial Femoropopliteal Vein Reconstruction. Arch Surg 1999; 134: 615-621.

8. Krajíček M, Peregrin JH, Roček M et al. Chirurgická a intervenční léčba cévních onemocnění. Praha: Grada Publishing 2007.

9. Petrik J, Roubal P, Kořístek V et al. Indikační problémy u cévních rekonstrukčních operací. Vnitř Lék 1991; 37: 336-341.

10. Podlaha J. Chirurgie extrakraniálního karotického řečiště. Praha: Grada Publishing 2006.

11. Raupach J, Lojík M, Krajina A et al. Infekční salmonelové aneuryzma břišní aorty: diagnostika, endovaskulární léčba. Rozhl Chir 2002; 81: 150-153.

12. Seeger JM, Pretus HA, Welborn MB 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; 32: 451-459.

13. Staffa R. Záchrana kriticky ischemické končetiny. Pedální bypass. Praha: Grada Publishing 2004.

14. Szilagyi ED, Smith RF, Elliott JP et al. Infection in Arterial Reconstruction with Synthetic Grafts. Ann Surg 1972; 176: 321-332.

15. Šefránek V et al. Ochorenia končatinových artérií a ich chirurgická liečba. Bratislava: Bratislava: Slovak Academy Press 2001.