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Experience with femoro-popliteal vein as a conduit for vascular reconstruction in infected fields

C P Gibbons1, C J Ferguson, L J Fligelstone

  • 1Department of Vascular Surgery, Morriston Hospital, Swansea SA6 6NL, UK.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|April 26, 2003
PubMed
Abstract

Insights

Femoro-popliteal vein grafts are effective for arterial reconstruction in sepsis, showing no limb loss and sustained graft patency. This approach, combined with debridement and antibiotics, is recommended for infected arterial or graft cases.

Area of Science:

  • Vascular Surgery
  • Infectious Disease Management
  • Graft Reconstruction

Background:

  • Sepsis poses significant challenges for arterial reconstruction.
  • Infected prosthetic grafts require urgent management.
  • Femoro-popliteal vein grafts offer a potential solution in complex cases.

Purpose of the Study:

  • To evaluate the outcomes of femoro-popliteal vein grafts used for arterial reconstruction in patients with sepsis.
  • To assess the efficacy of this technique in managing infected arterial and prosthetic grafts.

Main Methods:

  • Retrospective review of 26 patients undergoing 27 arterial reconstructions using femoro-popliteal vein grafts in the presence of infection.
  • Inclusion criteria: mycotic aneurysms, prosthetic graft infections, and one superior mesenteric artery reconstruction.
  • Surgical approach involved debridement, graft removal (if applicable), povidone-iodine washout, antibiotics, and graft placement in a clean field or omental wrap.

Main Results:

  • One early postoperative death (4%) and no instances of limb loss were recorded.
  • Graft patency and freedom from infection were maintained in all surviving patients from 1 month to 5 years (median 22 months).
  • Three major wound infections resolved without graft exposure; one rectus femoris flap required removal.

Conclusions:

  • Femoro-popliteal vein reconstruction, coupled with thorough debridement and appropriate antibiotic therapy, is a recommended treatment for arterial or graft infections.
  • This method demonstrates favorable outcomes in limb salvage and graft survival in septic environments.

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