Autogenous Superficial Femoral Vein for Replacement of an Infected Aorto-ilio-femoral Prosthetic Graft


Authors: R. Staffa 1;  Z. Kříž 1;  R. Vlachovský 1;  M. Dvořák 1;  T. Novotný 1;  J. Buček 1;  S. Šárník 2;  B. Vojtíšek 3
Authors‘ workplace: II. chirurgická klinika LF MU a FN u sv. Anny v Brně, přednosta: prof. MUDr. R. Staffa, Ph. D. 1;  I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně, přednosta: prof. MUDr. J. Vítovec, CSc., FESC. 2;  Klinika zobrazovacích metod LF MU a FN u sv. Anny v Brně, přednosta: doc. MUDr. P. Krupa, CSc. 3
Published in: Rozhl. Chir., 2010, roč. 89, č. 1, s. 39-44.
Category: Monothematic special - Original

Overview

A group of 12 patients (10 men, 2 women; average age, 52.7 years; range, 50–79 years) with vascular prosthetic graft infection (n = 9) or with an increased risk of such infection (n = 3) underwent arterial aorto-ilio-femoral reconstruction using autogenous superficial femoral vein. None of the patients died or had to have revision surgery during the follow-up (mean ± SD, 14.1 ± 7.3 months; range, 3–27 months). No pulmonary embolism occurred, nor were any early or late complications such as recurrent infection, graft occlusion, limb amputation or aneurysmal dilatation of vein graft recorded. In one patient, benign oedema of the limb following deep vein harvest persists, but this is well managed with a compression stocking.

The findings reported in the international literature as well as the authors’ experience show that the use of autogenous femoral vein gives very good results in the treatment of an infected vascular prosthetic graft, one of the most feared and most serious complications of vascular surgery.

Key words:
prosthetic graft infection – superficial femoral vein – deep femoral vein – autogenous reconstruction


Sources

1. Herman, J., Utíkal, P., Sekanina, Z., Bachleda, P. Infekce náhrad abdominální aorty. Rozhl. Chir., 2009; 88(7): 349–352.

2. Špaček, M., Bělohlávek, O., Votrubová J., Šebesta, P., Štádler P. Diagnostics of „non-acute” vascular prosthesis infection using 18F-FDG PET/CT: our experience with 96 prostheses. Eur. J. Nucl. Med. Mol. Imaging., 2009; 36(5): 850–858.

3. Štádler, P., Bělohlávek, O., Špaček, M., Michálek, P. Diagnosis of vascular prosthesis infection with FDG-PET/CT. J. Vasc. Surg., 2004; 40: 1246–1247.

4. Fukuchi, K., Ishida, Y., Higashi, M., Tsunekawa, T., Ogino, H., Minatoya, K., Kiso, K., Naito, H. Detection of aortic graft infection by fluorodeoxyglucose positron emission tomography: Comparison with computed tomographic findings. J. Vasc. Surg., 2005; 42(5): 919–925.

5. Bacourt, F., Koskas, F., and the French University Association for research in surgery. Axillobifemoral bypass and aortic exclusion for vascular septic lesions: a multicenter retrospective study of 98 cases. Ann. Vasc. Surg., 1992; 6: 119–126.

6. Quinones-Baldrich, W. J., Hernandes, J. J., Moore, W. S. Long-term results following surgical management of aortic graft infection. Arch. Surg., 1991; 126: 507–511.

7. Wasiková, S., Staffa, R., Kříž, Z., Piskač, P. Léčba infekce cévní protézy a aortoenterické píštěle jako pozdní komplikace rekonstrukčního výkonu na abdominální aortě – kazuistika. Rozhl. Chir., 2007; 86: 522–524.

8. Chiche, L., Pitre, J., Sarfati, P. O. In situ repair of a secondary aorto-appendiceal fistula with a rifampin-bonded Dacron graft. Ann. Vasc. Surg., 1999; 13: 225–228.

9. Batt, M., Magne, J. L., Alric, P., Muzj, A., Ruotolo, C., Ljungstrom, K. G., Garcia-Casas, R., Simms, M. In situ revascularization with silver-coated polyester grafts to treat aortic infection: early and midterm results. J. Vasc. Surg., 2003; 38(5): 983–989.

10. Oderich, G., Bower, T., Cherry, K., Panneton, J. Jr., Sullivan, T., Noel, A., Carmo, M., Cha, S., Karla, M., Gloviczki, P. Evolution from Axillofemoral to In Situ Prosthetic Reconstruction for the Treatment of Aortic Graft Infections at a Single Center. J. Vasc. Surg., 2006; 43(6): 1166–1174.

11. Noel, A. A., Gloviczki, P., Cherry, K. J. Jr., Safi, H., Goldstone, J., Morasch, M. D., Johansen, K. H. Abdominal aortic reconstruction in infected fields: early results of the United States cryopreserved aortic allograft registry. J. Vasc. Surg., 2002; 35(5): 847–852.

12. Kieffer, E., Gomes, D., Chiche, L., Fleron, M. H., Koskas, F., Bahnini, A. Allograft replacement for infrarenal aortic graft infection: early and late results in 179 patients. J. Vasc. Surg., 2004; 39: 1009–1017.

13. Clagett, G. P., Bowers, B. L., Polez-Viego, M. A., et al. Creation of neo-aortoiliac system from lower extremity deep and superficial veins. Ann. Surg., 1993; 218: 239–249.

14. Seeger, J. M., Wheeler, J. R., Gregory, R. T. Autogenous graft replacement of infected prosthetic grafts in the femoral position. Surgery, 1983; 93: 39–45.

15. Jicha, D. L., Reilly, L.M., Kuestner, L. M., Stoney, R. J. Durability of cross-femoral grafts after aortic graft infection: the fate of autogenous conduits. J. Vasc. Surg. 1995; 22(4): 393–405; discussion 406–407.

16. Clagett, G. P., Valentine, R. J., Hagino, R. T. Autogenous aortoiliac/femoral reconstruction from superficial femoral-popliteal veins: feasibility and durability. J. Vasc. Surg., 1997, 25(2): 255–266, discussion 267–270.

17. Nevelsteen, A., Lacroix, H., Suy, R. Autogenous reconstruction with lower extremity deep veins: an alternative treatment of prosthetic infection after reconstructive surgery for aortoiliac disease. J. Vac. Surg., 1995; 22: 129–134.

18. Franke, S., Voit, R. The superficial femoral vein as arterial substitute in infections of the aortoiliac region. Ann. Vasc. Surg., 1997; 11(4): 406–412.

19. Gordon, L. L., Hagino, R. T., Jackson, M. R., Modrall, J. G., Valentine, R. J., Clagett, G. P. Complex aortofemoral prosthetic infections: the role of autogenous superficial femoropopliteal vein reconstruction. Arch. Surg., 1999; 134(6): 615-20; discussion 620–621.

20. Gibbons, C. P., Ferguson, C. J., Edwards, K., Roberts, D. E., Osman, H. Use of superficial femoropopliteal vein for suprainguinal arterial reconstruction in the presence of infection. B. J. Surg., 2000; 87: 771–776.

21. Staffa, R. Tepenná náhrada odebraná z hlubokého žilního systému – prioritní operace v ČR. Medical Tribune 2007; 3(21): A1.

22. Staffa, R., Kříž, Z., Vlachovský, R. Hluboká žíla dolní končetiny jako tepenná náhrada při řešení infekce cévní protézy. Rozhl. Chir., 2008; 87(4): 186–189.

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Surgery Orthopaedics Trauma surgery

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