Institution of Surgical Sciences, Department of Vascular Surgery, Uppsala University, Uppsala, Sweden.
J Endovasc Ther. 2011 Oct;18(5):666-73. doi: 10.1583/11-3465.1.
To report an initial experience and midterm results of a novel hybrid technique (EndoVAC) combining stent-grafts, surgical revision, and vacuum-assisted wound closure (VAC).
All 10 patients (5 men; mean age 62 years) treated with the EndoVAC technique for infected vascular reconstructions (5 carotid, 4 femoral) or access sites (1 femoral and 1 brachial artery) between November 2007 and June 2010 were retrospectively reviewed. Follow-up included laboratory investigations, duplex ultrasonography, and imaging.
VAC therapy was applied for a median 15 days (range 9-54). Three complications occurred: a watershed infarction (dysphasia), a transient hypoglossal nerve palsy, and a late stent-graft thrombosis. Two patients died during treatment but with local infection under control. Over a median follow-up of 11 months (range 1-33), no recurrent infection was noted after healing of the skin in any of the 8 survivors.
The EndoVAC technique seems to be a promising option for treatment of infected vascular reconstructions in selected cases.
报告一种新型混合技术（EndoVAC）的初步经验和中期结果，该技术结合了支架移植物、手术修正和真空辅助伤口闭合（VAC）。
回顾性分析 2007 年 11 月至 2010 年 6 月期间，10 例（5 例男性；平均年龄 62 岁）接受 EndoVAC 技术治疗的感染性血管重建（5 例颈动脉，4 例股动脉）或入路（1 例股动脉和 1 例肱动脉）患者的资料。随访包括实验室检查、双功超声和影像学检查。
VAC 治疗的中位数为 15 天（范围 9-54 天）。发生了 3 种并发症：分水岭梗死（言语障碍）、一过性舌下神经麻痹和晚期支架移植物血栓形成。2 例患者在治疗过程中死亡，但局部感染得到控制。在 8 例存活患者中，中位随访 11 个月（范围 1-33 个月），皮肤愈合后均未再发生感染。
在选择的病例中，EndoVAC 技术似乎是治疗感染性血管重建的一种有前途的选择。
