Aim. Indications for the conservative treatment of graft infections. Methods. Nine patients who underwent surgery of the aortoiliac tract and later developed graft infection were treated using a conservative approach: 2 patients underwent surgical drainage and focused antibiotic therapy, whereas CT-guided percutaneous drainage of the perigraft fluid collection was associated with specific antibiotic therapy in 7 patients. Each patient was controlled both clinically and using ultrasonographic and CT scan once every 6 months. Results. The 2 patients treated surgically remained asymptomatic for 2 and 3 years respectively and died from non graft-related reasons. Among the 7 patients treated percutaneously, 4 recovered (mean follow-up=30.7 months), and in the other 3 cases an aortoduodenal fistula was reported in 2 cases, at the 75th and 77th postoperative month, leading to patient death. In the 3rd case, 4 months after drainage, the patient underwent surgical extra-anatomic revascularisation and died 3 months later from acute myocardial infarction. Conclusion. In the presence of a prosthetic infection, the treatment of choice should be graft excision coupled with extra-anatomic revascularisation or íin situî reconstruction. Percutaneous drainage represents a good option for non-complicated cases in which more aggressive treatment would increase the surgical risk. This diagnostic method can provide either useful confirmation of the microbiological diagnosis and, when diagnosis is prompt, as a first-line procedure, giving the chance of a complete recovery or permitting amelioration of the retroperitoneal environment in preparation for a surgical approach.

Ippoliti, A., DI GIULIO, L., Accrocca, F., Pampana, E., Gandini, R., Simonetti, G., et al. (2003). Graft infection: Conservative treatment [Infezione protesica: Trattamento conservativo]. GIORNALE ITALIANO DI CHIRURGIA VASCOLARE, 10(4), 347-359.

Graft infection: Conservative treatment [Infezione protesica: Trattamento conservativo]

IPPOLITI, ARNALDO;DI GIULIO, LORENZO;PAMPANA, ENRICO;GANDINI, ROBERTO;SIMONETTI, GIOVANNI MARIA EGISTO;
2003-01-01

Abstract

Aim. Indications for the conservative treatment of graft infections. Methods. Nine patients who underwent surgery of the aortoiliac tract and later developed graft infection were treated using a conservative approach: 2 patients underwent surgical drainage and focused antibiotic therapy, whereas CT-guided percutaneous drainage of the perigraft fluid collection was associated with specific antibiotic therapy in 7 patients. Each patient was controlled both clinically and using ultrasonographic and CT scan once every 6 months. Results. The 2 patients treated surgically remained asymptomatic for 2 and 3 years respectively and died from non graft-related reasons. Among the 7 patients treated percutaneously, 4 recovered (mean follow-up=30.7 months), and in the other 3 cases an aortoduodenal fistula was reported in 2 cases, at the 75th and 77th postoperative month, leading to patient death. In the 3rd case, 4 months after drainage, the patient underwent surgical extra-anatomic revascularisation and died 3 months later from acute myocardial infarction. Conclusion. In the presence of a prosthetic infection, the treatment of choice should be graft excision coupled with extra-anatomic revascularisation or íin situî reconstruction. Percutaneous drainage represents a good option for non-complicated cases in which more aggressive treatment would increase the surgical risk. This diagnostic method can provide either useful confirmation of the microbiological diagnosis and, when diagnosis is prompt, as a first-line procedure, giving the chance of a complete recovery or permitting amelioration of the retroperitoneal environment in preparation for a surgical approach.
2003
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/22 - CHIRURGIA VASCOLARE
English
Con Impact Factor ISI
Blood vessel prosthesis; Prosthesis-related infections, diagnosis; Prosthesis-related infections, surgery
Ippoliti, A., DI GIULIO, L., Accrocca, F., Pampana, E., Gandini, R., Simonetti, G., et al. (2003). Graft infection: Conservative treatment [Infezione protesica: Trattamento conservativo]. GIORNALE ITALIANO DI CHIRURGIA VASCOLARE, 10(4), 347-359.
Ippoliti, A; DI GIULIO, L; Accrocca, F; Pampana, E; Gandini, R; Simonetti, Gme; Pistolese, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/51655
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