Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2012 Vol. 20 No 1

LECTURES, REVIEWS

A.A. LYZIKOV

SURGICAL TACTICS AT ARTIFICIAL VASCULAR PROSTHESES INFECTION

EE Gomel State Medical University,
the Republic of Belarus

Different variants of surgical tactics at suppuration of the vascular prosthesis are described in the review. Basic variants of surgical tactics such as extraanatomic bypass, vascular prosthesis regrafting, appliance of allograft and femoral vein are proposed. Pros and cons of each method are shown. Comparative analysis of the performed techniques was performed. Indications and contraindications for each method are determined. Situations suitable for attempt of conservative treatment of infected prosthesis and regrafting by vascular prosthesis are described. Possible ways of prevention of the vascular prosthesis contamination are described in details. Different approaches to the antibiotics prevention of the infectious complications are listed. Step-by-step development of the prevention methods of the infectious complications is carried out.

Keywords: prosthesis infection, extraanatomic bypass, femoral vein, allograft, artificial prosthesis
p. 120 126 of the original issue
References
<p>1.O'Hara PJ, Hertzer NR, Beven EG, Krajewski LP. Surgical management of infected abdominal aortic grafts: review of a 25-year experience. J Vasc Surg. 1986 May;3(5):725 31.<br> 2.Reilly LM, Stoney RJ, Goldstone J, Ehrenfeld WK. Improved management of aortic graft infection: the influence of operation sequence and staging. J Vasc Surg. 1987 Mar;5(3):421 31.<br> 3.Quinones-Baldrich WJ, Hernandez JJ, Moore WS. Long-term results following surgical management of aortic graft infection. Arch Surg.126:507 12.<br> 4.Ricotta JJ, Faggioli GL, Stella A, Curl GR, Peer R, Upson J, D'Addato M, Anain J, Gutierrez I. Total excision and extra-anatomic bypass for aortic graft infection. Am J Surg. 1991 Aug;162(2):145 49.<br> 5.Leather RP, Darling RC 3rd, Chang BB, Shah DM. Retroperitoneal in-line aortic bypass for treatment of infected infrarenal aortic grafts. Surg Gynecol Obstet. 1992 Dec;175(6):491 94.<br> 6.Olah A, Vogt M, Laske A, Carrell T, Bauer E, Turina M. Axillo-femoral bypass and simultaneous removal of the aortofemoral vascular infection site: is the procedure safe? Eur J Vasc Surg. 1992 May;6(3):252 54.<br> 7.Bacourt F, Koskas F. Axillobifemoral bypass and aortic exclusion for vascular septic lesions: a multicenter retrospective study of 98 cases and the French University Association for Research in Surgery. Ann Vasc Surg. 1992; 6:119 21.<br> 8.Bandyk DF, Novotney ML, Back MR, Johnson BL, Schmacht DC. Expanded application of in situ replacement for prosthetic graft infection. J Vasc Surg. 2001 Sep;34(3):411 19; discussion 419 20.<br> 9.Clagett GP, Bowers BL, Lopez-Viego MA, Rossi MB, Valentine RJ, Myers SI, Chervu A. Creation of a neo-aortoiliac system from lower extremity deep and superficial veins. Ann Surg. 1993 Sep;218(3):239 48; discussion 248 49.<br> 10.Nevelsteen A, Lacroix H, Suy R. Autogenous reconstruction with the lower extremity deep veins: an alternative treatment of prosthetic infection after reconstructive surgery for aortoiliac disease. J Vasc Surg. 1995;22:129 32.<br> 11.Clagett GP, Valentine RJ, Hagino RT. Autogenous aortoiliac/femoral reconstruction from superficial femoral-popliteal veins: feasibility and disability. Vasc Surg. 1997;(5):55 68.<br> 12.Franke S, Voit R. The superficial femoral vein as arterial substitute in infections of the aortoiliac region. Ann Vasc Surg. 1997;(11):406 15.<br> 13. Brown PM Jr, Kim VB, Lalikos JF, Deaton DH, Bogey WM, Powell CS. Autologous superficial femoral vein for aortic reconstruction in infected fields. Ann Vasc Surg. 1999 Jan;13(1):32 6.<br> 14.Cardozo MA, Frankini AD, Bonamigo TP. Use of superficial femoral vein in the treatment of infected aortoiliofemoral prosthetic grafts. Cardiovasc Surg. 2002;(10):304 13.<br> 15.Gibbons CP, Ferguson CJ, Fligelstone LJ, Edwards K. Experience with femoro-popliteal vein as a conduit for vascular reconstruction in infected fields. Eur J Vasc Endovasc Surg. 2003 May;25(5):424 31.<br> 16.Daenens K, Fourneau I, Nevelsteen A. Ten-year experience in autogenous reconstruction with the femoral vein in the treatment of aortofemoral prosthetic infection. Eur J Vasc Endovasc Surg. 2003;25:240 54.<br> 17.Kieffer E, Bahnini A, Koskas F, Ruotolo C, Le Blevec D, Plissonnier D. In situ allograft replacement of infected infrarenal aortic prosthetic grafts: results in forty-three patients. J Vasc Surg. 1993 Feb;17(2):349-55; discussion 355 56.<br> 18.Vogt PR, Pfammatter T, Schlumpf R, Genoni M, Knzli A, Candinas D, Znd G, Turina M. In situ repair of aorto-bronchial, aortoesophageal, and aortoenteric fistulae with cryopreserved aortic homografts. J Vasc Surg. 1997 Jul;26(1):11 7.<br> 19.Ruotolo C, Plissonnier D, Bahnini A, Koskas F, Kieffer E. In situ arterial allografts: a new treatment for aortic prosthetic infection. Eur J Vasc Endovasc Surg. 1997 Dec;14(Suppl. A):102 107.<br> 20.Nevelsteen A, Feryn T, Lacroix H, Suy R, Goffin Y. Experience with cryopreserved arterial allografts in the treatment of prosthetic graft infections. Cardiovasc Surg. 1998 Aug;6(4):378 83.<br> 21.Chiesa R, Astore D, Piccolo G, Melissano G, Jannello A, Frigerio D, Agrifoglio G, Bonalumi F, Corsi G, Costantini Brancadoro S, Novali C, Locati P, Odero A, Pirrelli S, Cugnasca M, Biglioli P, Sala A, Polvani G, Guarino A, Biasi GM, Mingazzini P, Scalamogna M, Mantero S, Spina G, Prestipino F, et al. Fresh and cryopreserved arterial homografts in the treatment of prosthetic graft infections: experience of the Italian Collaborative Vascular Homograft Group. Ann Vasc Surg. 1998 Sep;12(5):457 62.<br> 22.Lesche G, Castier Y, Petit MD, Bertrand P, Kitzis M, Mussot S, Besnard M, Cerceau O.Long-term results of cryopreserved arterial allograft reconstruction in infected prosthetic grafts and mycotic aneurysms of the abdominal aorta. J Vasc Surg. 2001 Oct;34(4):616 22.<br> 23.Verhelst R, Lacroix V, Vraux H, Lavigne JP, Vandamme H, Limet R, Nevelsteen A, Bellens B, Vasseur MA, Wozniak B, Goffin Y. Use of cryopreserved arterial homografts for management of infected prosthetic grafts: a multicentric study. Ann Vasc Surg. 2000 Nov;14(6):602 07.<br> 24.Vogt PR, Brunner-LaRocca HP, Lachat M, Ruef C, Turina MI. Technical details with the use of cryopreserved arterial allograft for aortic infection: influence on early and midterm mortality. J Vasc Surg. 2002 Jan;35(1):80 6.<br> 25.Noel AA, Gloviczki P, Cherry KJ Jr, Safi H, Goldstone J, Morasch MD, Johansen KH; United States Cryopreserved Aortic Allograft Registry Abdominal aortic reconstruct in infected fields: early results of the United States Cryopreserved Aortic Allograft Registry. J Vasc Surg. 2002 May;35(5):847 52.<br> 26.Gabriel M, Pukacki F, Dzieciuchowicz A, Oszkinis G, CheciDski P. Cryopreserved arterial allografts in the treatment of prosthetic graft infections. Eur J Vasc Endovasc Surg. 2004 Jun;27(6):590 96.<br> 27.Teebken OE, Pichlmaier MA, Brand S, Haverich A. Cryopreserved arterial allografts for in situ reconstruction of infected arterial vessels. Eur J Vasc Endovasc Surg. 2004 Jun;27(6):597 602.<br> 28.Lavigne JP, Postal A, Kolh P, Limet R. Prosthetic vascular infection complicated or not by aortoenteric fistula: comparison of treatment with and without cryopreserved allograft (homograft). Eur J Vasc Endovasc Surg. 2003 May;25(5):416 23.<br> 29.Kieffer E, Gomes D, Chiche L, Flron MH, Koskas F, Bahnini A. Allograft replacement for intrarenal aortic graft infection: early and late results in 179 patients. J Vasc Surg. 2004 May;39(5):1009 17.<br> 30. Walker WE, Cooley DA, Duncan JM, Hallman GL Jr, Ott DA, Reul GJ. The management of aorto-duodeoal fistula by in situ replacement of the infected abdominal aortic graft. Ann Surg. 1987 Jun;205(6):727 32.<br> 31.Speziale F, Rizzo L, Sbarigia E, Giannoni MF, Massucci M, Maraglino C, Santoro E, Fiorani P. Bacterial and clinical criteria relating to the outcome of patients undergoing in situ replacement of infected abdominal aortic grafts. Eur J Vasc Endovasc Surg. 1997 Feb;13(2):127 33.<br> 32.Hayes PD, Nasim A, London NJ, Sayers RD, Barrie WW, Bell PR, Naylor AR.<br> In situ replacement of infected aortic grafts with rifampicin-bonded prostheses: the Leicester experience 1992 to 1998). J Vasc Surg. 1999 Jul;30(1):92 98.<br> 33.Young RM, Cherry KJ Jr, Davis PM, Gloviczki P, Bower TC, Panneton JM, Hallett JW Jr. The results of in situ prosthetic replacement for infected aortic grafts. Am J Surg. 1999 Aug;178(2):136 40.<br> 34.Batt M, Magne JL, Alric P, Muzj A, Ruotolo C, Ljungstrom KG, 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 Nov;38(5):983 89.<br> 35.Lehnert T, Gruber HP, Maeder N, Allenberg JR. Management of primary aortic graft infection by extra-anatomic bypass reconstruction. Eur J Vasc Surg. 1993 May;7(3):301 307. <br> 36.Sharp WJ, Hoballah JJ, Mohan CR, Kresowik TF, Martinasevic M, Chalmers RT, Corson JD The management of the infected aortic prosthesis: a current decade of experience. J Vasc Surg. 1994 May;19(5):844 50.<br> 37.Kuestner LM, Reilly LM, Jicha DL, Ehrenfeld WK, Goldstone J, Stoney RJ. Secondary aortoenteric fistula: contemporary outcome with use of extraanatomic bypass and infected graft excision. J Vasc Surg. 1995 Feb;21(2):184 95; discussion 195 96.<br> 38.Hannon RJ, Wolfe JHN, Mansfield AO. Aortic prosthetic infection: 50 patients treated by radical or local surgery. Br J Surg. 1996;83:654 59.<br> 39.Schmitt DD, Seabrook GR, Bandyk DF, Towne JB. Graft excision and extra-anatomic revascularization: the treatment of choice for the septic aortic prosthesis. J Cardiovasc Surg (Torino). 1990 May-Jun;31(3):327 32.<br> 40.Bunt TJ. Vascular graft infections: a personal experience. Cardiovasc Surg. 1993;(1):489 93.<br> 41.Seeger JM, Pretus HA, Welborn MB, Ozaki CK, Flynn TC, Huber TS. Long-term outcome after treatment of aortic graft infection with staged extraanatomic bypass grafting and aortic graft removal. J Vasc Surg. 2000 Sep;32(3):451 59; discussion 460 61.<br> 42.Dorigo W, Pulli R, Azas L, Pratesi G, Innocenti AA, Pratesi C. Early and long-term results of conventional surgical treatment of secondary aorto-enteric fistula. Eur J Vasc Endovasc Surg. 2003 Nov;26(5):512 18.<br> 43.Yeager RA, Taylor LM Jr, Moneta GL, Edwards JM, Nicoloff AD, McConnell DB, Porter JM.Improved results with conventional management of infrarenal aortic infection. J Vasc Surg. 1999 Jul;30(1):76 83.<br> 44.Modrall JG, Sadjadi J, Ali AT, Anthony T, Welborn MB 3rd, Valentine RJ, Hynan LS, Clagett GP. Deep vein harvest: predicting the need of fasciotomy. J Vasc Surg. 2004 Feb;39(2):387 94.<br> 45.Koskas F, Plissonnier D, Bahnini A, Ruotolo C, Kieffer E. In situ arterial allografting for aortoiliac graft infection: a 6-year experience. Cardiovasc Surg. 1996 Aug;4(4):495 99.<br> 46.Calligaro KD, Veith FJ, Schwartz ML, Goldsmith J, Savarese RP, Dougherty MJ, DeLaurentis DA.Selective preservation of infected prosthetic arterial grafts. Analysis of a 20-year experience with 120 extracavitary-infected grafts. Ann Surg. 1994 Oct;220(4):461 69; discussion 469 71.<br> 47.Morris GE, Friend PJ, Vassallo DJ, Farrington M, Leapman S, Quick CR. Antibiotic irrigation and conservative surgery for major aortic graft infection. J Vasc Surg. 1994 Jul;20(1):88 95.<br> 48.Blair M, Soulez G, Oliva VL, Laprrire J, Gianfelice D, Blair JF, Sarrazin J, Thrasse E. Aortic graft infection: the value of percutaneous drainage. AJR Am J Roentgenol. 1998 Jul;171(1):119 24. <br> 49.Caliigaro KD. Veith F.J. Graft-preserving methods for managing aortofemoral prosthetic graft infection. Eur J Vasc Endovasc Surg.1997;14(Suppl. A):38 45.<br> 50.Calligaro KD, Veith FJ, Yuan JG, Gargiulo NJ, Dougherty MJ. Intra-abdominal aortic graft infection: complete or partial graft preservation in patients at very high risk. J Vasc Surg. 2003 Dec;38(6):1199 205.<br> 51.Tambyraja AL, Chalmers RT. Conservative management of MRSAperiaortic graft abscess. Ann Vase Surg. 2003;17:676 82.<br> 52.Bandyk DF, Bergamini TM, Kinney EV, Seabrook GR, Towne JB.In situ replacement of vascular prostheses infected by bacterial biofilms. J Vasc Surg. 1991 May;13(5):575 83.<br> 53.Becquemin JP, Qvarfordt P, Kron J, Cavillon A, Desgranges P, Allaire E, Melliere D. Aortic graft infection: is there a place for partial graft removal? Eur J Vasc Endovasc Surg. 1997 Dec;14(Suppl. A):53 58.<br> 54.Miller JH. Partial replacement of an infected arterial graft by a new prosthetic polytetrafluoroethylene segment: a new therapeutic option. J Vasc Surg. 1993;17:546 54.<br> 55.Towne JB, Seabrook GR, Bandyk D, Freischlag JA, Edmiston CE. In situ replacement of arterial prosthesis infected by bacterial biofilms: long-term follow-up. J Vasc Surg. 1994 Feb;19(2):226 33; discussion 233 35.<br> 56.Sladm JG, Chen JC, Reid JDS. An aggressive local approach to vascular graft infection. Am J Surg. 1998;176:222 35.<br> 57.Kaiser AB, Clayson KR, Mulherin JL Jr, Roach AC, Allen TR, Edwards WH, Dale WA. Antibiotic prophylaxis in vascular surgery. Ann Surg. 1978 Sep;188(3):283 89.<br> 58.Pitt HA, Postier RG, MacGowan AW, Frank LW, Surmak AJ, Sitzman JV, Bouchier-Hayes D. Prophylactic antibiotics in vascular surgery: topical, systemic, or both? Ann Surg. 1980 Sep;192(3):356 64.<br> 59.Hasselgren PO, Ivarsson L, Risberg B, Seeman T. Effects of prophylactic antibiotics in vascular surgery. A prospective, randomized, double-blind study. Ann Surg. 1984 Jul;200(1):86 92.<br> 60.Hall JC, Christiansen KJ, Goodman M, Lawrence-Brown M, Prendergast FJ, Rosenberg P, Mills B, Hall JL. Duration of antimicrobial prophylaxis in vascular surgery. Am J Surg. 1998 Feb;175(2):87 90.<br> 61.Kurz A, Sessler DL, Lenhardt R. Study of Wound infection Group. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl Med J. 2000;342:161 67. </p>
Address for correspondence:
246050, Respublika Belarus', g. Gomel', ul. Lange, d.5, UO Gomel'skii gosudarstvennyi meditsinskii universitet, kafedra khirurgicheskikh boleznei 3 s kursom serdechno-sosudistoi khirurgii,
e-mail: Lyzikov@mail.ru,
Lyzikov Aleksei Anatol'evich
Information about the authors:
Lyzikov A.A. Candidate of medical sciences, associate professor of the surgical diseases chair 3 with the course of the cardiovascular surgery of EE Gomel State Medical University
Contacts | ©Vitebsk State Medical University, 2007