Prosthetic vascular graft infections: A center experience

Sousa, Juliana Varino; Antunes, Luís; Mendes, Carolina; Marinho, André; Gonçalves, Anabela; Gonçalves, Óscar F.; Matos, Ana Sofia

doi:10.1016/s1646-706x(14)70050-3

Cited by 23 publications

(23 citation statements)

References 8 publications

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“…Colonization with noncoagulase‐negative staphylococcus correlates with late infections. Proteus mirabils and other gram negative organisms are associated with high rupture and anastomotic failure rates . As seen in our case, empirical antibiotic treatment with anaerobic coverage should therefore be promptly administered to improve patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

An axillofemoral bypass graft transgressing the chest wall

Skervin

Thomas

Sritharan

2015

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

An axillofemoral bypass graft transgressing the chest wall

Skervin

Thomas

Sritharan

2015

Clinical Case Reports

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“…Увод Позитронска емисиона томографија (ПЕТ) са комјутеризованом томографијом (КТ) уз коришћење флуор-18-обележене флуордеоксиглукозе ( 18 Ф-ФДГ ПЕТ/КТ) јесте хибридна дијагностичка метода базирана на детекцији ћелијског накупљања глукозе, који корелира са степеном активности болести. Док друге дијагностичке методе немају могућност процене функције ткива, 18 4 Институт за ортопедску хирургију "Бањица", Београд, Србија; 5 Клинички центар Србије, Центар за радиологију и магнетну резонанцу, Београд, Србија…”

Section: сажетакunclassified

“…Right diagnosis is made based on blood tests, hemoculture, ultrasound, and computed tomography (CT) [3,4]. The most common causes of an infection are bacteria Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella and Enterococcus [5,6]. Medicament treatment implies elimination of an infective agent by various antibiotics (Tetracycline, Methicillin, Penicillin), but the treatment of choice for graft infections is surgical removal and graft replacement [7,8], which is why an accurate diagnosis is important to avoid unnecessary surgery.…”

Section: Introductionmentioning

confidence: 99%

Hybrid imaging of vascular graft infection by positron emission tomography with computed tomography using fluorine-18-labeled fluorodeoxyglucose: The Serbian National PET Center experience

et al. 2019

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Introduction Positron emission tomography (PET) with computed tomography (CT) using fluorine-18-labeled fluorodeoxyglucose (18 F-FDG PET/CT) is a hybrid diagnostic method based on the cell's glucose uptake detection, which correlates with the degree of disease activity. While other diagnostic procedures fail to evaluate functional tissue, 18 F-FDG PET/CT can be helpful in discovering active disease in patients with vascular graft infection. Methods This cohort retrospective study included 22 patients (17 male, five female; aged 61.7 ± 16.1) with suspected vascular graft infection. Blood analyses and CT were performed in all patients. Degree of glucose uptake was evaluated visually and semiquantitatively using maximal standardized uptake value (SUVmax). Findings were considered positive if focal fluoro-deoxyglucose (FDG) accumulation was greater in vascular graft projection than other parts of the blood vessel and liver. Results The sighs of active disease were found in 19 patients (86%) (16 male, three female) at the level of implanted vascular grafts: six aortobifemoral (27%), four aortoiliac (18.2%), four of abdominal aorta (18.2%), two of thoracic aorta (9.1%), two femoral (9.1%), one femoropopliteal (4.5%) (SUVmax 7.9 + 2.4). Two patients were considered true and one false negative-due to antibiotic usage, which reduces FDG uptake. PET/CT helped in treatment alteration of 12 patients, seven (31.8%) started new medicament therapy, five (22.7%) had a surgical graft replacement. Overall sensitivity of this method is 95%, specificity 100%, positive predictive value 100%, negative predictive value 66.6%, accuracy 95.4%. Conclusion 18 F-FDG PET/CT is a useful diagnostic method in detection of active vascular graft infection with high diagnostic accuracy, which is important in avoiding unnecessary surgery and appropriate therapy planning.

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“…The comparison of rifampin-impregnated and silver-coated vascular prostheses does not give convincing results in terms of better effi ciency in one or other type of vascular prosthesis in the treatment of AGI. Their advantage lies in the immediate availability but we have to count with higher number of re-infection rates ranging from 4 to 22 % (57,58,59).…”

Section: Treatment Optionsmentioning

confidence: 99%

Management of aortic graft infections – the present strategy and future perspectives

Treska¹,

Certík²,

Moláček³

2016

BLL

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Aortic graft infections (AGI) are serious complications of open and endovascular types of surgery with an incidence rate of 0.6-3 %. AGI are associated with 30-60 % perioperative mortality and 40-60 % morbidity rate with limb amputation rates between 10 % and 40 %. The economic cost of AGI is substantial. At the time of aortic reconstruction, almost 90 % of patients have one or more predisposing factors for AGI. The diagnosis is based on clinical symptomatology, laboratory markers, microbial cultures, and imaging modalities. The general principle of surgical treatment lies in the removal of infected graft, debridement of infected periprosthetic tissues, and vascular reconstruction by in situ or extra-anatomic bypass with long-term antibiotic therapy. The conservative treatment is used only for selected patients with endograft infection. This review summarizes the current knowledge about the incidence, predisposing factors, etiology, diagnosis, treatment options, and prevention of aortic vascular graft and endograft infections. With the growing number of endovascular procedures we can expect more cases of infected aortic endografts in patients with severe comorbidities in the near future, where the recent radical surgical approach (graft excision, debridement, and new revascularization) cannot be used. Therefore the less invasive, sophisticated and individualized treatment strategies will have to be used in search of the best therapeutic approach to each specifi c patient (Fig. 4, Ref. 82). Text in PDF www.elis.sk.

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Prosthetic vascular graft infections: A center experience

Cited by 23 publications

References 8 publications

An axillofemoral bypass graft transgressing the chest wall

An axillofemoral bypass graft transgressing the chest wall

Hybrid imaging of vascular graft infection by positron emission tomography with computed tomography using fluorine-18-labeled fluorodeoxyglucose: The Serbian National PET Center experience

Management of aortic graft infections – the present strategy and future perspectives

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