Influence of patient characteristics and treatment options on outcome of patients with prosthetic aortic graft infection

Abstract

This study was undertaken to determine the influence of patient characteristics and treatment options on survival and limb loss after treatment of prosthetic aortic graft infection. Fifty-three patients treated for prosthetic aortic graft infection were reviewed. Twenty-three presented with groin infection, 12 with sepsis, 10 with aortoenteric fistula, 4 with limb ischemia, and 4 with pseudoaneurysm. Treatment included staged extraanatomic bypass (EAB) plus graft excision in 23 patients, simultaneous EAB and graft excision in 18, in situ graft replacement in 5, and local therapy only in 7. Axillofemoral bypass was done for revascularization in 53 limbs and axillopopliteal bypass in 16 limbs. The results of this study showed that morbidity and mortality of prosthetic aortic graft infection is influenced by the presentation and type of treatment of the infected graft. Staged axillofemoral bypass (when possible) plus graft excision appears to be associated with acceptable outcome (survival with limb salvage in 74%).