Prosthetic vascular graft infections: A center experience

AbstractIntroductionProsthetic graft infection is a major complication of vascular surgery associated with high morbid-mortality rates. This retrospective non-randomized single center study evaluated our experience in the management of prosthetic vascular graft infections.MethodsWe review the clinical files of patients who had vascular grafts implanted at our center between June 2007 and December 2011 and analysed the cases that developed Samson group 3, 4 and 5 infections until December 2012.ResultsFrom June 2007 to December 2012, 18 consecutive patients (14 males, 4 females) with median age 70 years were admitted to our institution with the diagnosis of vascular graft infection accounting for an incidence of 3.8%. 50% of these infections were early infections and MRSA was the most prevalent pathogen. 44% of infections were due to infection of a femoro-popliteal bypass. Using Samson classification, 72% were group 4 and 5 infections. We performed graft preservation in one patient, graft excision without revascularization in 50% (nine) patients; Excision + insitu replacement in 39% (seven) patients; Excision + Extra-anatomic bypass in one patient. Our amputation rate was 55% and our related death rate was 16%.ConclusionsOur amputation and mortality rates are according the published reviews. Besides allowing recognition of our reality this offers the opportunity to review diagnosis and therapeutic issues in prosthetic vascular graft infections. Each situation needs to be individualized as there is no consensus nor guiding algorithms about what should be the best medical treatment