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Chirurgia 2006 February;19(1):57-9

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

In situ saphenous bypass in the treatment of infrainguinal synthetic graft infections

Sunar H., Ege T., Canbaz S., Çikirikçiodlu M., Edis M., Halici Ü., Duran E.

Trakya University Medical School Department of Cardiovascular Surgery, Edirne, Turkey


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Synthetic vascular graft infection is a challenging problem of the vascular surgery. Graft removal and subsequent new bypass establishment is usually necessary with special difficulties. We report two infrainguinal vascular graft infections treated by graft removal accompanying new bypass with in situ saphenous vein. Two patients with femoropopliteal polyterafluoroethylene (ptfe) graft bypass were admitted due to perigraft purulent collection. Culture materials were obtained by aspirating the perigraft cavities. Patients were treated with the new femoropopliteal insitu saphenous vein bypass via anastomosing outside of the infected area to the common femoral artery proximally and to the below knee popliteal artery distally. And then the subsequent removal of the old infected synthetic graft was performed simultaneously. Appropriate antimicrobial treatment was continued for 15 days postoperatively. Culture revealed methicilline resistant staphylococci in one patient and staphylococcus epidermidis in the other. Infection were eradicated by graft removal and appropriate antimicrobial treatment. Graft patency and limb salvage were also achieved for two patients in the mean follow up period of 10 months. No reinfection has occurred in both patients. In situ use of the saphenous vein, if it has not been used before, in the treatment of femoropopliteal graft infection should be preferred for it is autogenous conduit, the bypass is performed in clean anatomic planes and new bypass can be performed before graft removal.

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