title: In situ revascularisation with silver-coated polyester prostheses and arterial homografts in patients with aortic graft infection--a prospective, comparative, single-centre study.
abstract: OBJECTIVE
  The aim of our study was to evaluate the effectiveness of in situ revascularisation with the use of arterial homografts and silver-coated prostheses in the treatment of aortic graft infection.
  
  
  METHODS
  A total of 77 consecutive patients (74 males, three females, mean age: 58 years), hospitalised between 2001 and 2008, were enrolled into the study. Patients were assigned to three groups: group 1 (n = 24)--fresh arterial homograft with subsequent immunosuppression, group 2 (n = 26)--fresh arterial homograft without immunosuppression and group 3 (n = 27)--silver-coated prosthesis.
  
  
  METHODS
  The course of infection was assessed by scintigraphy with (99m)Technetium-labelled leucocytes, Duplex-Doppler ultrasound, angio-computed tomography (CT) and microbiological examination.
  
  
  RESULTS
  The mean follow-up was 22.8 (±10.1) months. There was a significant decrease in leucocyte accumulation around the graft among all groups (group 1: p = 0.012, group 2: p = 0.006 and group 3: p = 0.021). The postoperative mortality rate in groups 1,2 and 3 was 8%, 23% and 11%, respectively. The postoperative morbidity was 35% in group 2, 16% in group 1 and 7% in group 3.
  
  
  CONCLUSIONS
  Our study suggests that silver-coated prostheses can be as effective as arterial allografts in the treatment of infections of vascular prostheses.
authors.affiliation: Department of Vascular, General and Transplantation Surgery Medical University Wroclaw, Borowska 213, 50-556 Wroclaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Pupka
authors.forename: J
authors.initials: J
authors.lastname: Skora
authors.forename: D
authors.initials: D
authors.lastname: Janczak
authors.forename: T
authors.initials: T
authors.lastname: Plonek
authors.forename: J
authors.initials: J
authors.lastname: Marczak
authors.forename: T
authors.initials: T
authors.lastname: Szydełko
mesh_terms: D000085:Acetates; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis / Q000382:microbiology*; D020099:Coated Materials, Biocompatible; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D018030:Silver Compounds; D014184:Transplantation, Homologous
chemical_list: D000085:Acetates; D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; D011091:Polyesters; D011093:Polyethylene Terephthalates; D018030:Silver Compounds; C103100:silver acetate; D016572:Cyclosporine