Treatment Strategies of Major Prosthetic Vascular Graft Infections and Evaluation of Short Term Results: Retrospective Clinical Research Majör Protez Vasküler Greft Enfeksiyonlarının Tedavisi ve Erken Dönem Sonuçların Değerlendirilmesi: Retrospektif Klinik Araştırma
Turkiye Klinikleri Cardiovascular Sciences, cilt.33, sa.2, ss.45-53, 2021 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 33 Sayı: 2
- Basım Tarihi: 2021
- Doi Numarası: 10.5336/cardiosci.2020-80901
- Dergi Adı: Turkiye Klinikleri Cardiovascular Sciences
- Derginin Tarandığı İndeksler: Scopus, Academic Search Premier, EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.45-53
- Anahtar Kelimeler: Biocompatible materials, Hematoma, Prosthesis-related infections, Vascular grafting, Vascular prosthesis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Prosthetic vascular graft infections (PVGI) are up-to-date pathologies with challenging and various treatment strategies. In the account of PVGI; there are so many protocols considering diagnosis and treatment with the lack of evidence and proper guideline recommendation. In this study, we evaluated clinical manifestations and treatment outcomes of twenty-three patients with major PVGI. Material and Methods: We retrospectively collected the data of twenty-three patients with major PVGI among three hundred thirty-six patients who have surgically treated for peripheral artery diseases between 2011 and 2018. Demographical parameters, co-existing pathologies, and adverse events were included in our study according to current literature examples. Subgroups were formed by the location of PVGI and the Samson classification. Patients underwent either graft sparing or total graft excision surgical procedures. Early postoperative infection, additional arterial intervention, amputation, prolonged in-hospital stay, and mortality were recognized as adverse events. Results: Five patients were Class III (21.7%), nine patients were Class IV (39.1%) and nine patients were Class V (39.1%) of the Samson classification system. The number of patients with intra-cavitary PVGI is seven (30.4%), peripheral PVGI is sixteen (69.6%). We have found that the existence of perigraft hematoma is related to higher rates of postoperative vascular intervention. C-reactive protein levels are significantly higher in patients with previously implanted Dacron graft. The in-hospital rate of mortality is 17.4%. Conclusion: Multidisciplinary effort to publish a guideline to manage the overall process of PVGI is needed. Close follow-up and early intervention are vital. Top surgical performance should be performed with care and sterility protocols should be applied at maximum.