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 Ãin situÃ® 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.
|Tipologia:||Articolo su rivista|
|Citazione:||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.|
|IF:||Con Impact Factor ISI|
|Settore Scientifico Disciplinare:||Settore MED/22 - Chirurgia Vascolare|
|Revisione (peer review):||Sì, ma tipo non specificato|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||2003|
|Titolo:||Graft infection: Conservative treatment [Infezione protesica: Trattamento conservativo]|
|Autori:||Ippoliti, A; Di Giulio, L; Accrocca, F; Pampana, E; Gandini, R; Simonetti, GME; Pistolese, G|
|Appare nelle tipologie:||01 - Articolo su rivista|