Advanced Search

Home > Journals > Italian Journal of Vascular and Endovascular Surgery > Past Issues > Giornale Italiano di Chirurgia Vascolare 2003 December;10(4) > Giornale Italiano di Chirurgia Vascolare 2003 December;10(4):347-60



A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus

Frequency: Quarterly

ISSN 1824-4777

Online ISSN 1827-1847


Giornale Italiano di Chirurgia Vascolare 2003 December;10(4):347-60


Graft infection. Conservative treatment

Ippoliti A. 1, Di Giulio L. 1, Accrocca F. 1, Pampana E. 2, Gandini R. 2, Simonetti G. 2, Pistolese G. R. 1

1 Department and Specialisation School in Vascular Surgery
2 Department and Specialisation School in Radiodiagnostics “Tor Vergata” University of Rome, Rome

Aim. Indications for the con­ser­va­tive treat­ment of ­graft infec­tions.
Methods. Nine ­patients who under­went sur­gery of the aor­toi­liac ­tract and lat­er devel­oped ­graft infec­tion ­were treat­ed ­using a con­ser­va­tive ­approach: 2 ­patients under­went sur­gi­cal drain­age and ­focused anti­bi­o­tic ther­a­py, where­as CT-guid­ed per­cut­ane­ous drain­age of the per­i­graft ­fluid col­lec­tion was asso­ciat­ed ­with spe­cif­ic anti­bi­o­tic ther­a­py in 7 ­patients. Each ­patient was con­trolled ­both clin­i­cal­ly and ­using ultra­son­o­graph­ic and CT ­scan ­once eve­ry 6 ­months.
Results. The 2 ­patients treat­ed sur­gi­cal­ly ­remained asymp­to­mat­ic for 2 and 3 ­years respec­tive­ly and ­died ­from non ­graft-relat­ed rea­sons. Among the 7 ­patients treat­ed per­cut­ane­ous­ly, 4 recov­ered (­mean fol­low-up=30.7 ­months), and in the oth­er 3 cas­es an aor­tod­u­od­en­al fis­tu­la was report­ed in 2 cas­es, at the 75th and 77th post­op­er­a­tive ­month, lead­ing to ­patient ­death. In the 3rd ­case, 4 ­months ­after drain­age, the ­patient under­went sur­gi­cal ­extra-ana­tom­ic revas­cu­lar­isa­tion and ­died 3 ­months lat­er ­from ­acute myo­car­dial infarc­tion.
Conclusion. In the pres­ence of a pros­thet­ic infec­tion, the treat­ment of ­choice ­should be ­graft exci­sion cou­pled ­with ­extra-ana­tom­ic revas­cu­lar­isa­tion or ìin ­situî recon­struc­tion. Percutaneous drain­age rep­re­sents a ­good ­option for non-com­pli­cat­ed cas­es in ­which ­more aggres­sive treat­ment ­would ­increase the sur­gi­cal ­risk. This diag­nos­tic meth­od can pro­vide ­either use­ful con­fir­ma­tion of the micro­bi­o­log­i­cal diag­no­sis and, ­when diag­no­sis is ­prompt, as a ­first-­line pro­ce­dure, giv­ing the ­chance of a com­plete recov­ery or per­mit­ting ame­li­o­ra­tion of the ret­ro­per­i­to­neal envi­ron­ment in prep­ar­a­tion for a sur­gi­cal ­approach.

language: English, Italian


top of page