Usage of venous grafts in aorto-iliac reconstructive surgery.
The authors present their clinical experience utilizing venous grafts (greater saphenous vein and superficial femoral vein) in the aorto-femoral position.


METHODS
Span of study is five years. The situations when these techniques were implemented are as follows:-(A). Infected synthetic prosthesis and (B). aorto-iliac occlusive disease in younger patients. A. In synthetic prosthetic infections there are 2 situations: (1) IMMEDIATE INFECTION. Observed in 10 cases, from which 2 cases where of severe infection and 8 cases of superficial infection--localized in the postoperative wound--Scarpa triangle region (7 cases) and left para-rectal (1 case). Superficial infections were treated successfully by daily dressings, excision of necrotic debris, antibiotic-therapy according to local antibiogram (only cases involving local invasion), and of course secondary wound closure at a later on date. The 2 cases of severe graft infection required harvesting of the superficial femoral vein and its usage in the aorto-femoral position. (2) LATE INFECTIONS. 3 patients were diagnosed with late infection of the synthetic prosthesis. In 2 cases, the infection was localized in the Scarpa triangle region, and the third in the abdomen (at the level of the aortic anastomosis). B. Aorto-iliac occlusive disease in younger patients--2 cases benefited from an aorto-bifemoral bypass reconstruction using the superficial femoral vein, and 5 cases where the greater saphenous vein was used in the iliac position.


RESULTS
Only 1 patient with severe prosthetic infection died due to multiple organ dysfunctions after the operation; the rest survived without any major amputation.


CONCLUSIONS
the harvesting and usage of these venous grafts is sometimes the final solution for patients with synthetic prosthesis infection.
Popa
R
R
Gr. T. Popa University of Medicine and Pharmacy, Iaşi School of Medicine, St. Spiridon University Hospital Iaşi.
Grigoraş
Ioana
I
Zaib
Khawaja
K
Raza
A
A
Baroi
Genoveva
G
D001012:Aorta, Abdominal / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D005268:Femoral Vein / Q000637:transplantation*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*