Vascular graft infections

Abstract

Infection of a vascular reconstruction is an infrequent, but ominous, complication. The patient is at risk not only from the infection but also from the potential for ischemia if the conduit must be interrupted, replaced or removed. Because vascular grafts function as substitute conduits in the arterial circulation, vascular graft infections are approached with a greater sense of gravity than other surgical wound or prosthetic implant infections. A vascular graft infection may be associated with sepsis, erosion of the graft into the gastrointestinal tract, dehiscence of the graft-artery suture line, and result in hemorrhage or false aneurysm formation or rupture of the graft itself. The incidence of infection is less when autologous tissue is used for artery replacement or bypass compared with prosthetic bypass grafting, and this observation remains a compelling reason to use autologous conduits in the management of arterial trauma where contamination is frequent. However, routine replacement of aortic segments for aneurysmal or occlusive disease cannot use autologous tissue, as there is no large enough segment of conduit that can be sacrificed. © 2007 Springer-Verlag Berlin Heidelberg.