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Infection complicating aortoiliac surgery

J M Cormier, A S Ward, P Lagneau

    The Journal of Cardiovascular Surgery
    |May 1, 1980
    PubMed
    Summary

    Sepsis after aorto-iliac surgery is serious, especially with infected prostheses. Successful treatment for infected thromboendarterectomy involves iliac exclusion, while infected prostheses require removal and bypass, with omentopexy as a potential preventative measure.

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    Area of Science:

    • Vascular Surgery
    • Infectious Disease Management
    • Surgical Complications

    Background:

    • Sepsis complicating aorto-iliac surgery presents significant challenges.
    • A review of 25 cases from 1970-1976 highlights treatment outcomes and strategies.

    Purpose of the Study:

    • To analyze the outcomes of sepsis following aorto-iliac procedures.
    • To define optimal treatment strategies for infected thromboendarterectomy and infected prostheses.
    • To evaluate the prophylactic role of omentopexy.

    Main Methods:

    • Retrospective case review of 25 patients with sepsis post-aorto-iliac surgery.
    • Analysis of treatment approaches for infected thromboendarterectomy versus infected prostheses.
    • Assessment of mortality, amputation rates, and specific surgical interventions.

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    Main Results:

    • All 10 cases of infected thromboendarterectomy were successfully treated with iliac exclusion and bypass/graft.
    • Infected prostheses (19 cases) had a 26% mortality rate (5 deaths) and 16% amputation rate (3 amputations).
    • Specific surgical techniques for prosthesis infection and the benefit of omentopexy were discussed.

    Conclusions:

    • Iliac exclusion with bypass/graft is the preferred treatment for infected thromboendarterectomy.
    • Infected prostheses necessitate removal and revascularization via bypass (axillofemoral or femoro-femoral), with varied success.
    • Omentopexy may offer prophylactic benefits in aorto-iliac surgery to prevent infection.