Surgical Treatment of Infected Aortofemoral Grafts: A Fifteen-Year Experience:

During the last fifteen years, we performed a total of 855 aortofemoral re constructions. Fifteen (1.75%) grafts were surgically removed (completely or partially) owing to a severe infection (Szilagyi: Grade 3) at a mean of 66.3 months (SD ± 37.9) after their implantation. Diagnosis was always clinically evident. In 10 patients, the graft was partially removed (one or two limbs). In 3 of the 10, graft infection progressed requiring complete graft removal after a mean of 18.6 days. In the other 5 patients, the graft was removed "in toto" at the time of the first operation. In 9 cases, revascularization was accomplished by means of a "remote" takeoff reconstruction (thoracic aorta or axillary ar tery), whereas in 8 cases (3 recurred) reconstruction was performed with a "local" takeoff reconstruction (stump or aortoiliofemoral arteries). One patient was not revascularized, because the limb was already amputated.Recurrence of infection was higher in the patients treated by partial removal of the graft (p < 0....