Vascular graft infections: a personal experience

Area of Science:

• Vascular Surgery
• Infectious Diseases
• Microbiology

Background:

• Vascular graft infections pose significant challenges in patient management.
• Differentiating between aortic and peripheral graft infections is crucial for treatment strategies.

Purpose of the Study:

• To analyze the management and outcomes of vascular graft infections.
• To identify common pathogens and clinical presentations for aortic versus peripheral graft infections.

Main Methods:

• Retrospective review of 55 vascular graft infections managed over 8 years.
• Categorization of infections into aortic (22 patients) and peripheral (33 patients).
• Analysis of pathogens, clinical presentations, treatment approaches, and outcomes.

Main Results:

• Staphylococcus epidermidis was the predominant pathogen in aortic graft infections (18/22), often presenting as thrombosis or pseudoaneurysm.
• Staphylococcus aureus was the most common pathogen in peripheral graft infections (29/33), typically presenting as sepsis.
• Staged extra-anatomic reconstruction and graft resection were used for aortic infections; local therapy or graft resection with autologous reconstruction for peripheral infections.
• Mortality was 9.1% for aortic infections; amputation rates were 14% (aortic) and 12% (peripheral).

Conclusions:

• Management strategies for vascular graft infections should be tailored to the location (aortic vs. peripheral) and causative pathogen.
• Early recognition and appropriate surgical intervention are critical for limb salvage and reducing mortality in vascular graft infections.