Infected aortobifemoral prosthesis--a dreaded complication.
From 1980 to 1985 13 patients were identified with infected aortofemoral grafts. Potential predisposing factors identified included a history of multiple femoral arterial procedures (10 patients; 77%) as well as perioperative infections occurring at the time of a prior femoral operation (five patients; 38%). Patients presented with suppurative groin infections (11) or ruptured pseudoaneurysms (2). Two who had previously undergone bilateral amputations were managed by removal of their aortic grafts without revascularization. Eleven other patients were managed by excision of the entire prosthesis (6 aortic grafts), partial graft excision (five graft limbs) or local treatment alone (three graft limbs). Revascularization through uninfected tissue planes was performed on 14 limbs with salvage of 11 (limb salvage 79%); whereas three limbs not revascularized required major amputation (limb salvage 0%). Despite an aggressive surgical approach five patients (38%) required a major amputation and there were three deaths (23% mortality). Once the diagnosis of an infected graft is made, early graft excision and prompt revascularization are encouraged.
Schellack
J
J
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
Stewart
M T
MT
Smith
R B
RB
Perdue
G D
GD
Salam
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001011:Aorta / Q000601:surgery*; D001161:Arteriosclerosis / Q000601:surgery; D001424:Bacterial Infections / Q000188:drug therapy / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003131:Combined Modality Therapy; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents