Arterial graft infections. Delayed v immediate vascular reconstruction
W. D. Turnipseed, H. A. Berkoff, D. E. Detmer, C. W. Acher and F. O. Belzer
We evaluated the treatment and clinical outcome of 20 patients with major
abdominal vascular graft infections and found that immediate reconstruction
of arterial inflow to the lower extremities after complete removal of
contaminated graft material may not always be necessary or advisable.
Patients were treated by the following categories: group 1, graft removal
with immediate vascular reconstruction (seven patients, two aortoiliac and
five aortofemoral grafts); group 2, graft removal with delayed vascular
reconstruction (13 patients, three aortoiliac, five aortofemoral, and five
extra-abdominal grafts). The mortality (57%) and the incidence of major
amputation (14%) were highest when immediate vascular reconstruction was
attempted. Patient survival, the incidence of recurrent graft infection,
and the need for major amputation were favorably altered with delayed
reconstruction even when prosthetic material was used.
