Treatment of aortic graft infection with providone-iodine irrigation

Considerable morbidity and mortality are associated with infections of vascular prosthetic grafts. Most vascular surgeons believe that once vascular prosthetic graft infections occur, any form of therapy short of removal of the prosthesis will fail. Although recent reports have noted the successful conservative treatment of vascular prosthetic graft infections in the groin, most surgeons have been hesitant to use such therapy for aortic prosthetic graft infections. We describe an 88-year-old woman with an aortic graft infection 2 months after abdominal aortic aneurysmectomy who was treated successfully with local debridement and continuous irrigation of the graft bed with providone-iodine solution. Such local therapy is an alternative and sometimes effective method of managing patients with infected aortic grafts in whom the risk of resection of the prosthesis and revascularization would be prohibitive.