Autogenous reconstruction of infected arterial prosthetic grafts utilizing the superficial femoral vein.
BACKGROUND
Prosthetic infection after reconstructive vascular surgery is a most serious complication, associated with high mortality and amputation rates. Following excision of the infected graft, several methods of reconstruction are available. We present here our experience with autogenous reconstruction of infected prosthetic arterial grafts using the superficial femoral vein (SFV).


METHODS
From November 1995 to December 1999, we used the SFV in seven patients (mean age 70 years) for reconstruction of an infected aortobifemoral (n = 2), aortoiliac (n = 1), femorofemoral bypass (n = 1), femorotibial (n = 2) and carotid crossover bypass (n = 1). Treatment encompassed complete prosthetic excision and autogenous reconstruction with the SFV alone or as a spliced graft with the greater saphenous vein (GSV) or basilic vein.


RESULTS
There were no perioperative deaths or amputations. Two patients exhibited transient moderate swelling of the donor limb. In the follow-up, six patients are alive and well without any signs of recurrent infection. One patient died with an unrelated cause 24 months postoperatively. All donor limbs were asymptomatic for venous congestion in the long-term follow-up.


CONCLUSIONS
The SFV provides a reliable tool for autogenous reconstruction after resection of infected prosthetic arterial grafts. Harvesting the SFV is well tolerated as long as the deep femoral and the popliteal vein are preserved.
Dorweiler
B
B
Department of Cardiothoracic and Vascular Surgery, University Hospital, Johannes Gutenberg University, Mainz, Germany. dorweiler@htg.klinik.uni-mainz.de
Neufang
A
A
Schmiedt
W
W
Oelert
H
H
D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005268:Femoral Vein / Q000637:transplantation*; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome