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Updated: Mar 10, 2026

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Prophylactic antibiotics for percutaneous endovascular procedures.

N S Greaves1, E Katsogridakis1, B Faris1

  • 1Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|December 8, 2016
PubMed
Summary

Prophylactic antibiotics are crucial for preventing serious infections after endovascular procedures, despite limited data. Balancing benefits against risks like antimicrobial resistance is key for patient outcomes.

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Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Pharmacology

Background:

  • Percutaneous endovascular techniques are increasingly common for vascular disease, offering advantages over open surgery.
  • While endovascular procedures have lower infection rates than open surgery, infections that do occur are severe and can lead to limb loss or death.
  • The evidence for prophylactic antibiotic use in endovascular procedures is less robust than for open surgery.

Purpose of the Study:

  • To review the existing evidence on the use of prophylactic antibiotics in percutaneous endovascular procedures.
  • To highlight the need for further research, including randomized controlled trials, to guide clinical practice.
  • To discuss the balance between preventing infections and the potential downsides of antibiotic use.

Main Methods:

  • Literature review of studies on prophylactic antibiotics in endovascular procedures.
  • Analysis of guidelines from professional societies, such as the Society of Interventional Radiology.
  • Discussion of the benefits versus risks, including cost, antimicrobial resistance, and patient side effects.

Main Results:

  • Infectious complications from endovascular procedures, though less frequent, are devastating.
  • The Society of Interventional Radiology issued guidelines in 2010 based on limited evidence.
  • The number needed to treat to prevent one infection is high, but serious adverse outcomes can occur without prophylaxis.

Conclusions:

  • There is a need for high-quality randomized controlled trials to establish definitive guidelines for antibiotic prophylaxis in endovascular procedures.
  • Clinical decisions must weigh the benefits of infection prevention against the economic costs and risks of antimicrobial resistance.
  • Further research is essential to optimize patient care and reduce the incidence of severe endovascular prosthesis infections.