Infection complicating aortoiliac surgery.
25 cases of sepsis complicating aorto-iliac surgery have been encountered in the period 1970 to 1976 (8 cases occured in our own unit and 17 were received from elsewhere). There were 10 instances of infection following thromboendarterectomy and all 10 were treated successfully. Among the 19 patients with infected prostheses (14 primary, 5 secondary) there were 5 deaths(1 myocardial infarct, 2 septicaemia, 2 aortic haemorrhages) and 3 amputations. The treatment of choice for infected thromboendarterectomy cases is iliac exclusion coupled with either an obturator by-pass or a femoro-femoral vein graft using the perineal route. An infected prosthesis should be removed and circulation restored by means of an axillofemoral-bypass, or a femoro-femoral vein graft or a combination of the two. Occasionally an infected aorto-femoral prosthesis can be treated by removal of one limb only followed by obturator or axillo-femoral by-pass. The prophylactic value of omentopexy in aortoiliac surgery is emphasised.
D000671:Amputation, Surgical; D001011:Aorta / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000209:etiology; D001807:Blood Vessel Prosthesis; D004691:Endarterectomy / Q000009:adverse effects*; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007239:Infections / Q000209:etiology* / Q000628:therapy; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D012306:Risk; D018805:Sepsis / Q000209:etiology; D014184:Transplantation, Homologous; D014652:Vascular Diseases / Q000209:etiology; D014680:Veins / Q000637:transplantation