title: [Postoperative complications in vascular surgery].
abstract: The increase in numbers of vascular operations is due to a worldwide increase in vascular disease and diabetes. As a result of demographic changes, most of the vascular patients are comorbid and are therefore associated with multiple risk factors. Complications of vascular surgery can be divided into systemic, local non-vascular and vascular complications. Systemic complications are primarily caused by the patients' comorbidity. The prevalence of additional coronary heart disease and cerebral sclerosis accounts for approximately 40-60%, concomitant relevant stenoses of the renal arteries are documented in the literature in 23-42% of the cases. Special attention is paid to diabetes and its end-stage complications. Failure of wound healing, infection of the wound and lymphatic fistulas are the most common non-vascular complications. Inguinal incisions often give rise to a failure of wound healing caused by subcutaneous lymphatic vessels and because of the proximity to the anogenital region. Asepsis, atraumatic operative techniques and perioperative antimicrobial prophylaxis lead to a reduction of surgical site infections and healing delay. Failing grafts or infection of the bypass are the most common vascular complications. Early graft failures are often caused by inappropriate handling or operation techniques and long-term failure is often related to the bypass material. However, in peripheral vascular surgery, autologous veins are superior to synthetic grafts and provide advantages in cases of infection. Removal of an infected synthetic graft is discussed as well as in-situ or extra-anatomical reconstructions. This article reviews the postoperative complications of vascular surgery and their management.
authors.affiliation: Klinik und Poliklinik für Gefässmedizin, Universitäres Herzzentrum Hamburg GmbH, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg. holger_diener@yahoo.de
authors.forename: H
authors.initials: H
authors.lastname: Diener
authors.forename: A
authors.initials: A
authors.lastname: Larena-Avellaneda
authors.forename: E S
authors.initials: ES
authors.lastname: Debus
mesh_terms: D001157:Arterial Occlusive Diseases / Q000601:surgery*; D015897:Comorbidity; D048909:Diabetes Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012086:Reoperation; D012307:Risk Factors; D014656:Vascular Surgical Procedures
references.citation: Eur J Vasc Endovasc Surg. 2007;33 Suppl 1:S1-75
references.pmid: 17140820
references.citation: Dtsch Med Wochenschr. 2004 Feb 27;129(9):429-33
references.pmid: 14970914
references.citation: Ann Surg. 1972 Sep;176(3):321-33
references.pmid: 4262892
references.citation: J Antimicrob Chemother. 2005 Dec;56(6):996-9
references.pmid: 16269550
references.citation: Surg Infect (Larchmt). 2004 Summer;5(2):174-9
references.pmid: 15353114
references.citation: Eur J Vasc Endovasc Surg. 2004 Apr;27(4):357-62
references.pmid: 15015183
references.citation: Chirurg. 2003 Dec;74(12):1103-9
references.pmid: 14673532
references.citation: J Vasc Surg. 1988 Sep;8(3):236-46
references.pmid: 2458492
references.citation: Am J Hypertens. 1994 Jul;7(7 Pt 2):7S-12S
references.pmid: 7946184
references.citation: J Vasc Surg. 1994 May;19(5):844-50
references.pmid: 8170038
references.citation: J Vasc Surg. 2003 Jun;37(6):1263-9
references.pmid: 12764274
references.citation: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007 Mar;50(3):377-93
references.pmid: 17340231
references.citation: J Vasc Surg. 2000 Sep;32(3):451-9; discussion 460-1
references.pmid: 10957651
references.citation: Am J Surg. 1993 Mar;165(3):341-4
references.pmid: 8447539
references.citation: Surgery. 1985 Jul;98(1):81-6
references.pmid: 4012610
references.citation: Circulation. 2004 Aug 10;110(6):738-43
references.pmid: 15262830
references.citation: J Vasc Surg. 1999 Jul;30(1):76-83
references.pmid: 10394156
references.citation: J Cardiovasc Surg (Torino). 2007 Aug;48(4):477-83
references.pmid: 17653008
references.citation: Chirurg. 2008 May;79(5):495-506; quiz 507-8
references.pmid: 18414818
references.citation: Lancet. 2005 Nov 12;366(9498):1736-43
references.pmid: 16291068
references.citation: N Engl J Med. 1998 Apr 16;338(16):1105-11
references.pmid: 9545358
references.citation: Circulation. 1999 Sep 7;100(10):1043-9
references.pmid: 10477528
references.citation: Clin Infect Dis. 2004 Oct 1;39(7):885-910
references.pmid: 15472838
references.citation: J Vasc Surg. 2005 Oct;42(4):667-72
references.pmid: 16242552
references.citation: Cardiovasc Surg. 1997 Oct;5(5):486-9
references.pmid: 9464605
references.citation: J Vasc Surg. 2005 Jun;41(6):988-93
references.pmid: 15944598
references.citation: Ann Vasc Surg. 2001 Mar;15(2):182-5
references.pmid: 11265082
references.citation: J Vasc Surg. 2006 Jun;43(6):1166-74
references.pmid: 16765233
references.citation: Ann Surg. 2003 Sep;238(3):382-9; discussion 389-90
references.pmid: 14501504
references.citation: J Biomed Mater Res B Appl Biomater. 2005 Jul;74(1):601-7
references.pmid: 15909300
references.citation: Chirurg. 2007 Jul;78(7):583-4, 586-92
references.pmid: 17603776
references.citation: J Vasc Surg. 1993 Feb;17(2):349-55; discussion 355-6
references.pmid: 8433430
references.citation: Arch Surg. 1991 Apr;126(4):507-11
references.pmid: 2009068
references.citation: J Vasc Surg. 1994 Jun;19(6):1021-30
references.pmid: 8201703
references.citation: Ann Surg. 1975 Jun;181(6):850-2
references.pmid: 1138635
references.citation: Chirurg. 2007 Jul;78(7):611-9
references.pmid: 17593334
references.citation: J Vasc Surg. 2004 May;39(5):1009-17
references.pmid: 15111853
references.citation: Ann Surg. 1994 Sep;220(3):251-66; discussion 266-8
references.pmid: 8092895
references.citation: J Vasc Surg. 1984 Jan;1(1):36-44
references.pmid: 6481870
references.citation: Cochrane Database Syst Rev. 2007 Oct 17;(4):CD006353
references.pmid: 17943905
references.citation: Ann Vasc Surg. 2002 Nov;16(6):742-5
references.pmid: 12424558
references.citation: J Vasc Surg. 2007 Jul;46(1):71-8
references.pmid: 17606124
references.citation: Chirurg. 2003 Dec;74(12):1090-102
references.pmid: 14673531
references.citation: Eur J Vasc Endovasc Surg. 2005 Jun;29(6):633-7
references.pmid: 15878543
references.citation: J Vasc Surg. 1997 Feb;25(2):255-66; discussion 267-70
references.pmid: 9052560
references.citation: J Vasc Surg. 1999 Jul;30(1):92-8
references.pmid: 10394158
references.citation: J Vasc Surg. 2007 Sep;46(3):520-5; discussion 525
references.pmid: 17826238
references.citation: Am J Surg. 1978 Apr;135(4):499-504
references.pmid: 637195
references.citation: Ann Surg. 2000 Oct;232(4):466-79
references.pmid: 10998645
references.citation: Eur J Vasc Endovasc Surg. 2000 Nov;20(5):409-12
references.pmid: 11112457
references.citation: Ann Vasc Surg. 2005 Mar;19(2):154-60
references.pmid: 15776307
references.citation: J Vasc Surg. 2007 Jul;46(1):148-55
references.pmid: 17606135
references.citation: J Vasc Surg. 1986 May;3(5):725-31
references.pmid: 3701939
references.citation: Strahlenther Onkol. 2005 Jun;181(6):396-400
references.pmid: 15925983
references.citation: Zentralbl Chir. 2005 Jun;130(3):W28-37; quiz W38-41
references.pmid: 15965868
references.citation: JAMA. 2006 Jan 11;295(2):180-9
references.pmid: 16403930
references.citation: Eur J Vasc Endovasc Surg. 1997 Dec;14 Suppl A:99-101
references.pmid: 9467625