[Management of infected vascular grafts. Are there any factors predictive of early clinical success?].
The aim of the study was to define mortality and limb loss rates and to identify factors predictive of early clinical success in the management of infected vascular grafts. Clinical data of 40 patients were reviewed, evaluating comorbidity factors, laboratory findings, ischaemic symptoms, graft material and time of onset of infections. Diabetes and chronic renal insufficiency were reported in 15% of cases, malignancy in 10%, pathological C-reactive protein in 77.5% and leukocytosis in 60%. 52.5% of the patients presented with a disabling claudication, and 77.5% with an infected alloplastic graft. Early infection had developed in 57.5%. A total graft excision was performed in 72.5% of cases. Early complications were recorded in 32.5% of the patients, with a limb loss rate of 22.5% and a mortality rate of 10%. Total graft excision is the treatment of first choice in patients with an infected vascular graft. Patients presenting with critical ischaemia and early septic complications will experience poor clinical results in terms of limb loss and mortality. Pathological blood levels of C-reactive protein could help in the choice of treatment in unclear cases.
Asciutto
Giuseppe
G
Department of Vascular Surgery, St. Josef Hospital, Ruhr Universität, Bochum, Germany.
Marpe
Barbara
B
Grossefeld
Marcus
M
Hummel
Thomas
T
Mumme
Achim
A
Geier
Bruno
B
D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis