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Human vascular graft failure and frequency of infection
1Unit 37 INSERM, Bron, France.
Abstract:
Among 212 vascular prostheses collected in a vascular explant retrieval program, 50 exhibited one or more criteria of graft infection i.e., (a) clinical evidence of graft infection, (b) positive bacteriological analyses of the graft, and (c) presence at the blood-prosthetic interface of characterized microorganisms. Whereas each of these criteria was noted respectively in 25, 26, and 20 cases, there was no complete overlapping among the three criteria, but their combination led us to consider 50 cases of infected vascular grafts among the 212 collected. These results, and the occurrence in two cases among six investigations for viral infection, suggest that extensive bacteriological investigations of vascular explants should be included in an implant retrieval program, and that infection may represent a high risk in graft failure.
Insights
Infection is a significant risk in vascular graft failure. Extensive bacteriological analysis of explanted vascular grafts is crucial for identifying graft infections and improving implant retrieval programs.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Biomaterials Science
Background:
- Vascular prostheses are essential in treating vascular diseases.
- Graft infection is a serious complication leading to graft failure.
- Implant retrieval programs are vital for understanding device performance.
Purpose of the Study:
- To determine the prevalence and criteria for diagnosing vascular graft infections.
- To assess the role of infection in vascular prosthesis failure.
- To evaluate the utility of bacteriological analysis in implant retrieval.
Main Methods:
- Analysis of 212 explanted vascular prostheses from a retrieval program.
- Assessment based on clinical evidence, bacteriological analysis, and microbial presence at the blood-prosthetic interface.
- Investigation of viral infections in a subset of cases.
Main Results:
- 50 out of 212 vascular prostheses (23.6%) met criteria for graft infection.
- Infection criteria included clinical signs (25 cases), positive bacteriology (26 cases), and microbial interface presence (20 cases).
- No single criterion was universally present; combined criteria identified 50 infected grafts. Viral infection was detected in 2 of 6 investigated cases.
Conclusions:
- Infection is a significant factor contributing to vascular graft failure.
- Comprehensive bacteriological investigation of explanted grafts is recommended for implant retrieval programs.
- Routine microbiological assessment can enhance the understanding and management of vascular prosthesis complications.