Vascular graft infections

Abstract

Vascular graft infections are rare complications after surgical and endovascular treatment of aortic diseases. This condition is characterized by complexity in diagnosis and medico-surgical management. Moreover, even if properly treated, morbidity and mortality rates are high. Although several advances have been made over the years and guidelines of treatment have been published, there is still debate on the optimal care for this disease. With local microbiological patterns and multiresistant strains conditioning antimicrobial treatment as well as several surgical debridement techniques in the armamentarium, it is difficult to offer recommendations that can be generalized for every single case. In this review, we aim at describing thoracic and abdominal vascular graft infections and providing current information on diagnosis, medical treatment, and surgical management.

Significance and current approaches to vascular graft infection

“…There is evidence that VGEI starts preoperatively by inoculation with bacteria from the patient’s skin flora at the time of surgery. This has been well addressed by Hasse et al [ 10 ] and Van Hemelrijck et al [ 14 ]. This is particularly significant in the case of prosthetic vascular graft infection (VGI) in the groin due to surgical site infection [ 10 ] and continues to be a major issue in vascular surgery.…”

Infection of Vascular Prostheses: A Comprehensive Review

“…In fact, in thoracic VEGIs, mainly gram-positive bacteria, like those found in infective endocarditis, can be found (Staphylococcus aureus, Coagulase-negative Staphylococcus, Enterococcus, and Streptococcus). On the other hand, Gram-negative bacteria and polymicrobial infections can be isolated in abdominal VGEIs [35].…”

“…Moreover, it is not possible to scale the intensity of the criteria, and this may be limiting in certain cases. Therefore, the further assessment and validation of novel criteria (maybe with an intensity score) adapted for different districts are required in future studies [35,73]. cell (WBC) scintigraphy based on the capacity of a radiolabeled granulocyte to reach the infection site and to accumulate in infectious tissues.…”

“…Moreover, it is not possible to scale the intensity of the criteria, and this may be limiting in certain cases. Therefore, the further assessment and validation of novel criteria (maybe with an intensity score) adapted for different districts are required in future studies [35,73].…”

“…Considering the rarity of this disease, current literature is not specialized as it lacks randomized controlled trials and studies with high patient population. Furthermore, current clinical evidence is based on small case studies, which are very often retrospective in nature [35].…”