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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2005 September;12(3):83-90
Management of extracavitary prostheses infection. Personal experience in 23 cases
Asciutto G. 1, Barbera L. 2, Geier B. 3, Carmignani A. 1, Spinelli F. 1, Mumme A. 3
1 Department of Vascular Surgery, Policlinico G. Martino University of Messina, Messina, Italy
2 Department of Vascular Surgery Klinikum Bremen-Mitte, Bremen, Germany
3 Department of Vascular Surgery St. Joseph Hospital, Ruhr Universität, Bochum, Germany
Aim. A recent experience with infrainguinal graft infections was reviewed in the effort to identify factors relating to limb loss and mortality.
Methods. The records of 23 patients who had operative treatment of 23 episodes of infrainguinal graft infection between January 1999 and December 2004 were reviewed. Time of onset, diabetes mellitus, renal insufficiency, grade of ischemia presence of malignancy, a previous operative vascular intervention on the same leg affected by the infectious process were evaluated as factors possibly affecting outcome.
Results. The amputation rate was 26%. Of the factors studied, only the presence of an early infection in patients with an early infection was associated with bad results. The in-hospital mortality rate was 13%. A secondary procedure was needed in 43% of the patients. A high rate of success was reported in patients who underwent a total graft excision and who had a patent collateral circulation.
Conclusion. Graft infection remains a challenging problem. The treatment must be individualised according to the severity of the arterial disease and to the extension of the infectious process. The complete removal of the infected graft represents sometimes the only choice to life salvage in case of clinical signs of an advanced infectious process.