Vascular prosthesis infection in aorto-femoral position presents a life-threatening complication. Two operative modalities are utilized in the authors center: own superficial femoral veins (SFVR) and silver salts bonded anatomic reconstruction (AgR).
<bold>The aim of the study</bold> was comparison of the two treatment methods in terms of early and distant clinical results
<bold>Material and methods.</bold> 35 patients were qualified for infected aorto-femoral graft removal. In years 2000-2004 SFVR was conducted in 19 patients and in years 2005-2007 16 patients had AgR done. These groups were compared in terms of demographic, co-morbidity, vascular reconstructions history, infection symptoms and bacterial contamination. Then treatment results analysis was performed including: operation course, mortality, postoperative morbidity, amputation rate and further observation results.
<bold>Results.</bold> There were no differences in demographic and co-morbidity between the groups. First operation/clinical symptoms onset interval was significantly longer for AgR patients (8 vs 3.3 years, p=0.001). Purulent inguinal sinus was dominating infection manifestation in both groups. Swab results were similar for both groups (Gram+ species dominated in both). Analysis of course and results of operative treatment revealed that AgR operation time was shorter than SFVR (195 vs 317, p<0.001), intraoperative blood requirement was also lower for AgPR (1.6 vs 3.1, p<0.05). Postoperative death, postoperative bleeding, reinterventions and amputation rate were higher for SFVR than AgR, however differences were not significant. During follow-up no infection recurrence was observed.
<bold>Conclusions.</bold> We believe that AgPR is superior comparing with SFVR for patients with infected vascular prosthesis in the aorto-femoral prosthesis. Further investigations are mandatory to confirm our results.
Financed by the National Centre for Research and Development under grant No. SP/I/1/77065/10 by the strategic scientific research and experimental development program:
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