title: EndoVAC, a novel hybrid technique to treat infected vascular reconstructions with an endograft and vacuum-assisted wound closure.
abstract: OBJECTIVE
  To report an initial experience and midterm results of a novel hybrid technique (EndoVAC) combining stent-grafts, surgical revision, and vacuum-assisted wound closure (VAC).
  
  
  METHODS
  All 10 patients (5 men; mean age 62 years) treated with the EndoVAC technique for infected vascular reconstructions (5 carotid, 4 femoral) or access sites (1 femoral and 1 brachial artery) between November 2007 and June 2010 were retrospectively reviewed. Follow-up included laboratory investigations, duplex ultrasonography, and imaging.
  
  
  RESULTS
  VAC therapy was applied for a median 15 days (range 9-54). Three complications occurred: a watershed infarction (dysphasia), a transient hypoglossal nerve palsy, and a late stent-graft thrombosis. Two patients died during treatment but with local infection under control. Over a median follow-up of 11 months (range 1-33), no recurrent infection was noted after healing of the skin in any of the 8 survivors.
  
  
  CONCLUSIONS
  The EndoVAC technique seems to be a promising option for treatment of infected vascular reconstructions in selected cases.
authors: Institution of Surgical Sciences, Department of Vascular Surgery, Uppsala University, Uppsala, Sweden. bjorn.kragsterman@surgsci.uu.se
authors: Björn
authors: B
authors: Kragsterman
authors: Martin
authors: M
authors: Björck
authors: Anders
authors: A
authors: Wanhainen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D001916:Brachial Artery / Q000601:surgery*; D002339:Carotid Arteries / Q000601:surgery*; D003131:Combined Modality Therapy; D003646:Debridement; D020878:Device Removal; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects / Q000401:mortality; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D000900:Anti-Bacterial Agents