Successful surgical treatment of infected aorto-femoral­ bifurcation prosthesis by its explantation and bifurcation bypass grafting outside the area of previous reconstruction. Clinical case description

Abstract

Vascular graft infections are associated with a significant risk of mortality and morbidity and cost approximately $640 million per year in the United States. Clinical pattern depends on the time elapsed since the implantation and surgery location. A thorough collection of medical history and physical examination in combination with various imaging methods are often necessary to confirm a diagnosis. There are several treatment options for infected aortic grafts, including graft excision with extra-anatomic bypass grafting, in situ reconstruction or neo-aortoiliac system reconstruction. The treatment of infected endovascular aortic grafts is similar. In cases of infected peripheral shunts, graft preservation techniques may be used, but if these are not feasible, graft removal and revascularization through uninfected tissues are necessary. The authors discuss the diagnosis, general management and surgical approaches to the treatment of infected vascular grafts, as well as a clinical case of successful surgical management of an infected aortofemoral bifurcation prosthesis by its explantation and bifurcation bypass grafting outside the area of previous reconstruction. Keywords: graft infection, reconstructive surgery, re-intervention