Own Superficial Femoral Vein Versus Silver Bonded Artificial Graft in Patients with Vascular Prosthesis Infection in Aorto-Femoral Position: Treatment Results Comparison

摘要

Own Superficial Femoral Vein Versus Silver Bonded Artificial Graft in Patients with Vascular Prosthesis Infection in Aorto-Femoral Position: Treatment Results ComparisonVascular prosthesis infection in aorto-femoral position presents a life-threatening complication. Two operative modalities are utilized in the authors center: own superficial femoral veins (SFVR) and silver salts bonded anatomic reconstruction (AgR).The aim of the study was comparison of the two treatment methods in terms of early and distant clinical resultsMaterial and methods. 35 patients were qualified for infected aorto-femoral graft removal. In years 2000-2004 SFVR was conducted in 19 patients and in years 2005-2007 16 patients had AgR done. These groups were compared in terms of demographic, co-morbidity, vascular reconstructions history, infection symptoms and bacterial contamination. Then treatment results analysis was performed including: operation course, mortality, postoperative morbidity, amputation rate and further observation results.Results. There were no differences in demographic and co-morbidity between the groups. First operation/clinical symptoms onset interval was significantly longer for AgR patients (8 vs 3.3 years, p=0.001). Purulent inguinal sinus was dominating infection manifestation in both groups. Swab results were similar for both groups (Gram+ species dominated in both). Analysis of course and results of operative treatment revealed that AgR operation time was shorter than SFVR (195 vs 317, p<0.001), intraoperative blood requirement was also lower for AgPR (1.6 vs 3.1, p<0.05). Postoperative death, postoperative bleeding, reinterventions and amputation rate were higher for SFVR than AgR, however differences were not significant. During follow-up no infection recurrence was observed.Conclusions. We believe that AgPR is superior comparing with SFVR for patients with infected vascular prosthesis in the aorto-femoral prosthesis. Further investigations are mandatory to confirm our results.