[Bacteriophages in Vascular Surgery - an Alternative Curative Therapeutic Approach for Graft Infections]

Vascular graft infections pose as severe complications in vascular surgery and are linked to high morbidity and mortality. Guidelines recommend resection of infected grafts and concomitant autologous reconstruction, though redo-surgery might not always be reasonable in high-risk patients with significant comorbidities. Additionally, conservative antibiotic treatment is hindered by increasing antibiotic resistance rates and biofilm formation.Bacteriophages are viruses that selectively infect and eradicate bacteria and are therefore a promising anti-infective therapeutic strategy. Though the therapeutic potential of bacteriophages has been known since the early 20th century, in western medicine only a few clinical studies on bacteriophage treatment in infectious diseases exist to date.This review aims to outline history, biology and challenges of bacteriophage therapy. It summarizes 9 cases published in literature as case reports or small case series in which the treatment of vascular graft infections with bacteriophages is used to circumvent high-risk graft explantation surgery.