Management of Patients with Prosthetic Vascular Graft Infection

American Surgeon - Tập 66 Số 2 - Trang 166-177 - 2000
James M. Seeger1
1Section of Vascular Surgery, University of Florida College of Medicine, Gainesville, Florida

Tóm tắt

Management of patients with infected prosthetic vascular grafts is one of the most difficult challenges faced by the vascular surgeon. Patients often present with nonspecific symptoms, but delay in treatment can lead to life-threatening sepsis and/or hemorrhage. Fortunately, prosthetic vascular graft infection is uncommon, with the incidence varying between 1 and 6 per cent, depending on the location of the graft. Initially, the potentially infected vascular graft should be imaged using either CT or magnetic resonance imaging, with radionuclide studies being reserved for those instances in which imaging studies do not confirm or exclude the diagnosis of infection. Current treatments for prosthetic vascular graft infection include attempted graft preservation, graft removal with in situ graft replacement (using autogenous or new prosthetic grafts), and graft removal with extra-anatomic bypass. Morbidity and mortality associated with treatment, likelihood of long-term limb salvage, and likelihood of persistent or recurrent infection vary among these types of treatment. Therefore, in an individual patient with a prosthetic vascular graft infection, many things must be considered to appropriately determine the treatment most likely to achieve eradication of the infection and long-term limb salvage with the lowest risk. Regardless, with appropriate application of the techniques currently available for treatment of prosthetic vascular graft infection, long-term elimination of infection and limb preservation can be achieved in the great majority of patients with this grave problem.

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Tài liệu tham khảo

Liekweg WG, 1977, Surgery, 81, 335

Yeager RA, 1992, AnnVasc Surg, 6, 485

Padberg FT, 1995, Arch Surg, 130, 183, 10.1001/archsurg.1995.01430020073013

Southern FN, Eidt JF, Barnes RW, Moursi MM. Thrombosis and infection in aorta femoral bypass grafts. Presented at the 23rd Annual Meeting of the Southern Association for Vascular Surgery, January 1999.

10.1148/radiology.175.1.2315475

Qvarfortdt PG, 1985, Am J Surg, 150, 227, 10.1016/0002-9610(85)90125-4

Olofsson PA, 1988, J Vasc Surg, 8, 99, 10.1016/0741-5214(88)90394-1

Spartera C, 1990, Eur J Vasc Surg, 4, 69, 10.1016/S0950-821X(05)80041-6

10.1067/mva.1986.avs0030042

10.1016/S0950-821X(89)80044-1

10.2214/ajr.154.2.2136964

10.1007/s100169900276

Calligaro KD, 1994, Ann Surg, 20, 461, 10.1097/00000658-199410000-00005

10.1016/S0741-5214(95)70058-7

10.1016/0741-5214(93)90252-H

10.1016/0741-5214(93)90420-Q

10.1016/S0741-5214(99)70180-1

10.1016/S0741-5214(94)70098-2

10.1097/00000658-197011000-00001

10.1016/0741-5214(87)90049-8

10.1016/S0741-5214(99)70178-3

Ehrenfeld WK, 1979, Surgery, 85, 82

Seeger JM, 1983, Surgery, 93, 39

10.1016/S0741-5214(97)70347-1

10.1016/S0741-5214(95)70106-0

10.1016/0741-5214(84)90182-4

Seeger JM, Pretus HA, Ozaki KC, Long-term outcome in patients with aortic graft infection treated with staged extra-anatomic bypass and aortic graft removal. Accepted for presentation at 24th Annual Meeting of The Southern Association for Vascular Surgery, January 2000.

10.1097/00000658-198706000-00015

Eastcott HHG, 1982, Extra-Anatomic and Secondary Arterial Reconstruction, 58

Stoney RJ, 1992, Arch Surg, 127, 1191, 10.1001/archsurg.1992.01420100049008

DiMuzio PJ, 1996, J Vasc Surg, 24, 328, 10.1016/S0741-5214(96)70188-X

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American Surgeon

Tập 66 Số 2

166-177

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