Arterial infections in the new millenium: an old problem revisited

Area of Science:

• Vascular Surgery
• Infectious Diseases
• Grafting Techniques

Background:

• Infected aneurysms and arterial infections rapidly progress, leading to rupture and sepsis.
• Standard treatments include in situ grafting, resection with bypass, or ligation.

Purpose of the Study:

• To review recent experiences with arterial infections.
• To present long-term follow-up data for in situ cryopreserved allografts (CPAs).

Main Methods:

• Retrospective review of ten patients treated between January 2000 and June 2005.
• Infection sites included infrarenal abdominal aorta, femoral artery, and splenic artery.
• Treatment modalities: in situ CPAs, aortic resection with bypass, prosthetic grafting, and ligation.

Main Results:

• Five of six patients with infected aortas experienced rupture; two of three with femoral aneurysms had recurrent hemorrhage.
• Five aortic infections and two femoral infections were treated with in situ CPAs.
• Postoperative mortality for aortic infections was 50%, primarily in septic patients; survivors showed good long-term outcomes with intact grafts.

Conclusions:

• In situ grafting with CPAs is a reasonable option for arterial infections, demonstrating structural integrity and resistance to recurrence.
• High mortality in abdominal aortic infections correlates with preoperative sepsis.
• CPAs show promise in managing complex arterial infections.