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Management and Outcome of Prosthetic Vascular Graft Infections: A Single Center Experience

机译：假体血管接枝感染的管理和结果：单一中心经验

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摘要

Background: Prosthetic vascular graft infection (PVGI) remains a severe and challenging complication in vascular surgery with high morbidity and mortality rates. Incidence has been reported between 1% and 6%. The aim of this study was to report our experience in terms of general and surgical management as well as outcome, over 15 years. Methods: A retrospective consecutive study was conducted of all patients treated in our department for PVGI between January 2000 and December 2015. We analyzed all data relative to primary operation, duration interval between initial surgery and infections signs, infection site, type of microorganism involved, and surgical treatment modality, as well as evaluation of short- and long-term results. Results: Sixty-two patients were admitted for PVGI. Primary revascularization procedures consisted of a peripheral bypass in 42 (68%) patients and an aortic bypass in the remaining 20 (32%) patients. Median interval between primary procedure and reintervention was 3 months (interquartile range 17 [IQR 17]) in the peripheral group and 48 months (IQR 70.5) in the aortic group. Complete excision of the prosthetic graft was carried out in 85% of the cases. Thirty-day mortality was 0% and 9.5% in the aortic and peripheral group, respectively. The overall survival rate was 62.3% at 2-years, 46.4% in the aortic group, and 69.7% in the peripheral group. Conclusions: Prosthetic vascular graft infection needs a multidisciplinary management with appropriate antibiotherapy, radical removal of the infected graft, and in situ reconstruction. This strategy gives satisfactory results in terms of mortality, morbidity, patency rates, and infection control.
机译：背景：假肢血管移植感染（PVGI）仍然是血管手术的严重和挑战性并发症，具有高发病率和死亡率。报告的发病率为1％和6％。本研究的目的是向一般和手术管理以及超过15年的经验报告我们的经验。方法：通过2015年1月至2015年12月在我们的PVGI部门治疗的所有患者进行了回顾性的研究。我们分析了相对于初级操作，初始手术和感染症状，感染现场，涉及的微生物类型之间的持续时间间隔的所有数据，和手术治疗方式，以及对短期和长期结果的评估。结果：62例患者被录取PVGI。原发性血运重建程序包括42例（68％）患者的外周旁路和剩余的20（32％）患者的主动脉旁路。主要过程和重新纳入之间的中位间隔为3个月（在外周组中的3个月（四分位数17 [IQR17]）和主动脉组中的48个月（IQR 70.5）。在85％的病例中进行了假体移植的完全切除。分别在主动脉和外周组中的三十天死亡率为0％和9.5％。总生存率为2年的62.3％，在主动脉组中为46.4％，外周组69.7％。结论：假体血管接枝感染需要多学科管理，具有适当的抗疗法，受感染的移植物的根治性去除，以及原位重建。该策略在死亡率，发病率，通用率和感染控制方面具有令人满意的结果。

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  • 来源
    《Vascular and endovascular surgery》 |2018年第3期|共7页
  • 作者

    Maxime Elens; Muzhakkir Dusoruth; Parla Astarci; Stefano Mastrobuoni; Michel J. Bosiers; Jane Nardella; Valérie Lacroix; Julien Possoz; Robert Verhelst;

  • 作者单位

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

    Department of Vascular Surgery St Franziskus Hospital and University Clinic of Münster Münster;

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

    Department of Cardiovascular and Thoracic Surgery St Luc Hospital Catholic University of Louvain;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 心脏血管和淋巴系外科学;
  • 关键词

    vascular graft; prosthetic; synthetic; infection;

    机译：血管移植;假肢;合成;感染;

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