Aguiar E T, Albers M T, Langer B, Fratezi A C, Furlan J C
Departamento de Cirurgia, Faculdade de Medicina, Universidade São Paulo.
Rev Hosp Clin Fac Med Sao Paulo. 1993 Mar-Apr;48(2):76-81.
This article is to evaluate the results of surgical treatment of aorto-femoral graft infections. The records of 20 patients with aorto-femoral graft infections were reviewed. The patients were submitted mostly to a combination of surgical procedures. They were: a) conservative treatment; b) partial removal of the infected graft and c) total removal of the infected graft. The removal of the prosthesis, partial or total, was followed by a new arterial reconstruction in some patients. The final treatment was: total removal of the infected graft in 11 (55%) patients, total removal plus arterial reconstruction in six, partial removal in two and partial removal plus arterial reconstruction in one. The results of treatment were presented as the survival rate and the effective palliation (patient alive, lower limbs preserved and infection cured). The survival rates after one month, 12, 24, 36 and 48 months were respectively: 80%, 60%, 53%, 42% and 27%. The effective palliation rates after one month and after 48 months were respectively 50% and 27%. The highest effective palliation rate was obtained when the infected prosthesis was removed and a new arterial reconstruction performed. We conclude that the treatment of choice of aorto-femoral graft infections seems to be the total removal of the graft followed by new arterial reconstruction.
本文旨在评估主-股动脉移植感染的外科治疗结果。回顾了20例主-股动脉移植感染患者的病历。这些患者大多接受了多种外科手术联合治疗。手术方式包括：a）保守治疗；b）部分切除感染的移植物；c）完全切除感染的移植物。部分或完全切除假体后，部分患者进行了新的动脉重建。最终治疗结果为：11例（55%）患者完全切除感染的移植物，6例患者完全切除移植物并进行动脉重建，2例患者部分切除移植物，1例患者部分切除移植物并进行动脉重建。治疗结果以生存率和有效缓解率（患者存活、下肢保留且感染治愈）呈现。1个月、12个月、24个月、36个月和48个月后的生存率分别为：80%、60%、53%、42%和27%。1个月和48个月后的有效缓解率分别为50%和27%。当切除感染的假体并进行新的动脉重建时，有效缓解率最高。我们得出结论，主-股动脉移植感染的首选治疗方法似乎是完全切除移植物，随后进行新的动脉重建。
