Spiral vein grafts as vascular conduits in irradiated and contaminated tissue beds: a report of five cases with midterm followup

Use of the autologous spiral vein graft: a two-stage iliac bypass in a potentially fatal case of pelvic trauma and contaminated tissues

Serious problems may be encountered in arterial or venous reconstruction in cases of severe trauma and contaminated tissues. We report the use of a spiral venous graft (SVG) in a case of two-stage bypass aimed at saving first life, and then the extremity.

Severe open and contaminated injury was present in the lower abdomen and pelvic region of 29-year-old woman brought to the emergency department following a traffic accident. The patient was in shock, and was taken for emergency surgery jointly with the relevant departments. Interposition bypasses with synthetic graft were performed in the first stage. The synthetic grafts were subsequently removed due to problems developing secondary to infection at subsequent follow-up, and revascularization was established with autologous grafts together with SVG.

SVGs are alternative grafts in cases with contaminated tissues and requiring major vessel reconstruction. This technique can add to the therapeutic options available.

Gram-negative groin sepsis treated with covered stents and systemic antibiotics

Prosthetic graft infections are hazardous conditions. Those due to Gram-negative bacteria are particularly serious. When Gram-negative microorganisms are present, entire graft excision is recommended, with revascularization if needed, preferably with autogenous tissues or with prosthetic grafts via non-infected planes if autogenous options are not available. We herein report the case of a diabetic man with critical limb ischemia, who after lower-extremity revascularization with a prosthetic graft, developed an early graft infection due to Gram-negative and fungal organisms, and who was successfully treated with a covered stent placed across grossly infected tissues. A discussion on the pertinent literature is also offered.