Abstract:

Extra anatomic bypass is developed to provide adequate blood flow to extremities with occlusive disease associated with different surgical riscs. 3 patients who had undergone aorto-iliac and six patients who had undergone aorto-femoral bypass surgery previously at our or other departments during the period of 1992-2001 and have still graft infection were included in this study. Routine blood analyses and antibiogram test were performed. Aortography coronary arteriography ve leukocyte scintigraphy were performed in all patients. Mean age was 58±7 years. Aortography revealed graft occlusion in 4 patients and the grafts were patent in 5 patients. Leukocyte scintigraphy showed diffuse leukocyte infiltration at graft area in all patients. There occured no regression in infection altough combined parenteral antibiotic therapy and local wound care. Aorto-femoral or aorto-iliac grafts were removed and at the same time axillo-femoral bypass operation was performed in all patients. Combined antibiotic therapy was continued. After mean 3±0.4 months follow up period infecton dissapeared and leukocyte scinti-graphy findings returned to normal. In view of this findings once again aorto-femoral or aorto-iliac bypass operation was performed and axillo-femoral grafts were removed. There was no finding indicating graft infection in mean 14.6±3 months follow up period. Control DSA revealed that all grafts were patent. As a result, we suggested that removal of the infected graft and performing axillo-femoral bypass operation in patients with infected aorto-bifemoral/aortobiiliac bypass graft, is useful in terms of morbidity until dissapprearence of infection and insertion of a new aorto-iliac or aorto-femoral graft.

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