Ten-year experience in autogenous reconstruction with the femoral vein in the treatment of aortofemoral prosthetic infection.
OBJECTIVE
to study the short and long term effectiveness of in situ replacement of infected aortic grafts with the lower extremity deep veins.


METHODS
forty-nine patients operated on for infrarenal aortic graft infection since 1990 were studied. Diagnosis of infection was based on clinical signs, bacteriological tests and typical findings on CT scan and leukocyte scan. The surgical treatment consisted in harvesting the femoral vein, total graft excision, thorough debridement and in situ reconstruction with the femoral veins. After discharge, the patients were followed at 6 monthly intervals with clinical examination, duplex and/or CT scan.


RESULTS
there were four in-hospital deaths (8%). One patient required above-knee amputation (2%) and there were two graft limb occlusions (4%). With a mean follow-up 41 months, another 13 patients died, unrelated to the operation (29%). There were no late amputations and only two late graft limb stenoses (4%). We have a 5 year survival rate of 60%, a 5 year limb salvage rate of 98%, and a 5 year primary patency rate of 91%. There were no cases of aneurysmal dilatation of vein grafts and no incidence of reinfection.


CONCLUSIONS
in situ reconstruction with the lower extremity deep veins is in the long term a safe and attractive alternative in the treatment of infrarenal aortic graft infection.
Daenens
K
K
Center for Vascular Diseases, University Hospital Gasthuisberg, Leuven, Belgium.
Fourneau
I
I
Nevelsteen
A
A
D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005268:Femoral Vein / Q000637:transplantation*; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016459:Prosthesis-Related Infections / Q000401:mortality / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome