Preservation of an infected arterial graft with combination systemic-topical antibiotic therapy

A case is presented which illustrates the unusual ability to retain a bifurcation aortofemoral vascular graft with the graft-to-femoral-artery anastomosis involved in a groin abscess. The drainage of the abscess, debridement of devitalized tissue, and the combined application of topical and systemic antibiotic therapy was successful. Some authors report that should an anastomosis of a bifurcation vascular graft, in the vicinity of the groin, become involved in infection, the threat of anastomotic disruption and continued sepsis may lead to amputation, death, or both. It is not the purpose of this report to advocate conservative management of a vascular graft infection with suture line involvement based on anecdotal experience. However, the case reported here and the experience of other authors mentioned suggest that an attempt to treat an infected graft without its removal may be indicated in selected patients where extra anatomical revascularization would be hazardous.