title: Use of superficial femoropopliteal vein for suprainguinal arterial reconstruction in the presence of infection.
abstract: BACKGROUND
  Conventional treatment of mycotic aneurysms or graft infections of the aortoiliac segment by in situ or extra-anatomic prosthetic reconstruction has a high mortality and morbidity rate, with a substantial risk of persistent graft infection. The use of autologous vein may reduce this.
  
  
  METHODS
  Eleven patients with suprainguinal arterial infections including two with mycotic aortic aneurysms, four with aortic graft infections, four infected femorofemoral grafts and an infected axillofemoral graft were treated by debridement and in situ reconstruction with autologous superficial femoropopliteal vein. All patients received appropriate antibiotic therapy and were followed by regular postoperative duplex imaging. Preoperative femoral vein duplex imaging was performed in eight of the 11 patients.
  
  
  RESULTS
  Ten of the 11 patients survived with a functioning graft and without limb loss or evidence of infection at 4-33 months. One patient died from myocardial infarction after operation. Three patients had minor swelling of one leg. Four patients required subsequent angioplasty of anastomotic stenoses detected by duplex surveillance.
  
  
  CONCLUSIONS
  Superficial femoropopliteal vein is an excellent conduit for suprainguinal reconstruction in the presence of infection. Duplex imaging is useful for confirming the suitability of deep veins for use as a graft and for postoperative surveillance.
authors.affiliation: Department of Vascular Surgery, Morriston Hospital, Swansea, UK.
authors.forename: C P
authors.initials: CP
authors.lastname: Gibbons
authors.forename: C J
authors.initials: CJ
authors.lastname: Ferguson
authors.forename: K
authors.initials: K
authors.lastname: Edwards
authors.forename: D E
authors.initials: DE
authors.lastname: Roberts
authors.forename: H
authors.initials: H
authors.lastname: Osman
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D005260:Female; D005268:Femoral Vein / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000601:surgery*; D011152:Popliteal Vein / Q000637:transplantation*; D013530:Surgical Wound Infection / Q000601:surgery*