Local Complications After Arterial Bypass Grafting

Overview

Journal Ann R Coll Surg Engl

Specialty General Surgery

Date 1994 Mar 1

PMID 8154807

Citations 4

Authors

W B Campbell

L J Tambeur

V R Geens

Affiliations

Soon will be listed here.

Abstract

We have documented prospectively the problems occurring after 496 arterial bypass grafts (149 aortoiliac, 238 femorodistal, 65 extra-anatomic, and 44 others) implanted during the period 1987 to 1991 in a district general hospital. Postoperative bleeding occurred early in 14 (2.8%), and later (because of infection) in 3 (0.6%). Early graft occlusion (< 30 days) was seen in 2.9% aortofemoral, 10.4% femoropopliteal, and 25.3% femorotibial grafts, and amputation was required after 6.9% grafts. Wound problems were most common after femorotibial bypass--weeping of fluid in 3% and dehiscence or infection in 13.9%. Lymphatic collections occurred after 1.2% operations involving groin incisions. Graft sepsis was usually late, affecting 6% aortofemoral, 2.9% femorodistal, and 7.7% extra-anatomic grafts, but no intra-abdominal aortic grafts. These figures are probably representative of the complication rates seen by many surgeons and serve as an example for comparison and criticism.

Citing Articles

Cadaveric aorta implantation for aortic graft infection.

Ali A, Bahia S, Ali T Int J Surg Case Rep. 2016; 25:120-7.

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How To Diagnose and Manage Infected Endografts after Endovascular Aneurysm Repair.

Setacci C, Chisci E, Setacci F, Ercolini L, De Donato G, Troisi N Aorta (Stamford). 2016; 2(6):255-64.

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Strategies for managing aortoiliac occlusions: access, treatment and outcomes.

Clair D, Beach J Expert Rev Cardiovasc Ther. 2015; 13(5):551-63.

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Ten-year audit of arterial surgery from a district hospital.

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References

Lorentzen J, Nielsen O, Arendrup H, Kimose H, BILLE S, Andersen J . Vascular graft infection: an analysis of sixty-two graft infections in 2411 consecutively implanted synthetic vascular grafts. Surgery. 1985; 98(1):81-6. View

Hertzer N, AVELLONE J, Farrell C, Plecha F, Rhodes R, Sharp W . The risk of vascular surgery in a metropolitan community. With observations on surgeon experience and hospital size. J Vasc Surg. 1984; 1(1):13-21. View

Reifsnyder T, Bandyk D, Seabrook G, Kinney E, Towne J . Wound complications of the in situ saphenous vein bypass technique. J Vasc Surg. 1992; 15(5):843-8; discussion 848-50. DOI: 10.1067/mva.1992.36658. View

Bjerkelund C, Smith-Erichsen N, Solheim K . Abdominal aortic reconstruction. Prognostic importance of coexistent diseases. Acta Chir Scand. 1986; 152:111-5. View

OHara P, Hertzer N, Beven E, Krajewski L . Surgical management of infected abdominal aortic grafts: review of a 25-year experience. J Vasc Surg. 1986; 3(5):725-31. View

Bandyk D, Kaebnick H, Stewart G, Towne J . Durability of the in situ saphenous vein arterial bypass: a comparison of primary and secondary patency. J Vasc Surg. 1987; 5(2):256-68. DOI: 10.1067/mva.1987.avs0050256. View

Bergqvist D, Ljungstrom K . Hemorrhagic complications resulting in reoperation after peripheral vascular surgery: a fourteen-year experience. J Vasc Surg. 1987; 6(2):134-8. DOI: 10.1067/mva.1987.avs0060134. View

Schwartz M, HARRINGTON E, Schanzer H . Wound complications after in situ bypass. J Vasc Surg. 1988; 7(6):802-7. DOI: 10.1067/mva.1988.avs0070802. View

Johnson J, Cogbill T, Strutt P, Gundersen A . Wound complications after infrainguinal bypass. Classification, predisposing factors, and management. Arch Surg. 1988; 123(7):859-62. DOI: 10.1001/archsurg.1988.01400310073012. View

10.

Najmaldin A, Clifford P, Farrands P, Campbell M, Chant A, Webster J . The success of in situ vein grafting: early results in comparison with the reversed vein technique. Eur J Vasc Surg. 1987; 1(3):165-8. DOI: 10.1016/s0950-821x(87)80043-9. View

11.

Wengrovitz M, Atnip R, Gifford R, Neumyer M, Heitjan D, Thiele B . Wound complications of autogenous subcutaneous infrainguinal arterial bypass surgery: predisposing factors and management. J Vasc Surg. 1990; 11(1):156-61; discussion 161-3. DOI: 10.1067/mva.1990.16918. View

12.

Taylor Jr L, Edwards J, Porter J . Present status of reversed vein bypass grafting: five-year results of a modern series. J Vasc Surg. 1990; 11(2):193-205; discussion 205-6. DOI: 10.1067/mva.1990.17235. View

13.

Brennan T, Leape L, Laird N, Hebert L, Localio A, Lawthers A . Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med. 1991; 324(6):370-6. DOI: 10.1056/NEJM199102073240604. View

14.

Campbell W . Mortality statistics for elective aortic aneurysms. Eur J Vasc Surg. 1991; 5(2):111-3. DOI: 10.1016/s0950-821x(05)80673-5. View

15.

Hickey N, Thomson I, Shearman C, Simms M . Aggressive arterial reconstruction for critical lower limb ischaemia. Br J Surg. 1991; 78(12):1476-8. DOI: 10.1002/bjs.1800781222. View

16.

Craver J, Ottinger L, DARLING R, Austen W, LINTON R . Hemorrhage and thrombosis as early complications of femoropopliteal bypass grafts: causes, treatment, and prognostic implications. Surgery. 1973; 74(6):839-45. View

17.

Goldstone J, Moore W . Infection in vascular prostheses. Clinical manifestations and surgical management. Am J Surg. 1974; 128(2):225-33. DOI: 10.1016/0002-9610(74)90097-x. View

18.

STARR D, Lawrie G, MORRIS Jr G . Prevention of distal embolism during arterial reconstruction. Am J Surg. 1979; 138(6):764-9. DOI: 10.1016/0002-9610(79)90293-9. View

19.

Pitt H, Postier R, MacGowan A, Frank L, Surmak A, Sitzman J . Prophylactic antibiotics in vascular surgery. Topical, systemic, or both?. Ann Surg. 1980; 192(3):356-64. PMC: 1344917. DOI: 10.1097/00000658-198009000-00011. View

20.

Salzmann G . Perioperative infection prophylaxis in vascular surgery--a randomized prospective study. Thorac Cardiovasc Surg. 1983; 31(4):239-42. View