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Anastomotic femoral pseudoaneurysm: an investigation of occult infection as an etiologic factor. J Vasc Surg 1990 May;11(5):629-34

Date

05/01/1990

Pubmed ID

2139897

DOI

10.1067/mva.1990.19708

Scopus ID

2-s2.0-0025287111   53 Citations

Abstract

Occult infection was investigated as an etiologic factor in the formation of femoral anastomotic pseudoaneurysms associated with prosthetic vascular grafts. Forty-five femoral pseudoaneurysms with no clinical evidence of infection 10 to 173 months after prosthetic graft placement were consecutively studied. The explanted Dacron or explanted polytetrafluoroethylene graft material was cultured in trypticase soy broth and ultrasonically oscillated to remove adherent bacteria. All patients were treated by excision of the pseudoaneurysm and surrounding perigraft capsule and in situ replacement with an interposition prosthetic graft. Thirty-two bacterial isolates were recovered from 27 (60%) of the specimens, with coagulase negative staphylococci (Staphylococcus epidermidis S. warneri, S. hominis, S. capitis) accounting for 24 of the recovered species. No infection of the replacement graft developed in any patient and no recurrent pseudoaneurysms were observed. Bacterial colonization may occur at implantation or during subsequent procedures when the prosthetic graft is exposed. This chronic infection can be diagnosed by means of sensitive culture techniques that dislodge adherent bacteria from the graft surface. On grounds of the observations reported in this study, there appears to be suggestive evidence that an occult infectious process may be one of the factors that play a role in the development of some femoral anastomotic pseudoaneurysms.

Author List

Seabrook GR, Schmitt DD, Bandyk DF, Edmiston CE, Krepel CJ, Towne JB

Author

Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Anastomosis, Surgical
Aneurysm
Bacterial Adhesion
Blood Vessel Prosthesis
Cefazolin
Femoral Artery
Graft Occlusion, Vascular
Humans
Middle Aged
Polyethylene Terephthalates
Polytetrafluoroethylene
Popliteal Artery
Postoperative Complications
Premedication
Reoperation
Staphylococcal Infections
Staphylococcus
Thrombosis
jenkins-FCD Prod-398 336d56a365602aa89dcc112f077233607d6a5abc