ANTIBIOTIC BONDED POLYESTER GRAFT - ECLEC TIC INDICATIONS

Objective Infection is a major complication in vascular stents. Stents impregnated with gelatine and dipped in Rifampicin have been shown to resist methicillin-resistant Staphylococcus aureus in both animal exp eriments and in man. It has been suggested that ail aorto-ilio-femoral stents should be treated. To evaluate this method, we reassessed all stent infections observed in our patients who had undergone revascular ization of the lower limbs from January 1985 to 1994. We excluded sten ts implanted for ruptured aneurysms or implanted in patients with a pa st history of local infection on vascular stents. Results The rate of septic complications observed during the first year was 1 % for all pa tients in the series, 0 % for aorto-aortic and aorto-biiliac stents an d 0.7 % for aorto- bifemoral stents. These rates are similar to those reported in the multicentric study directed by Goeau Brissoniere using antibiotic impregnated stents. The extra cost involved in using such stents for aorto-ilio-femoral revascularization was estimated in this series at 2,180,000 Francs. The costs resulting from the three infecti ons was estimated at 960,000 Francs. Conclusion Based on the findings in this series, antibiotic impregnated stents should be indicated only in selected patients due to the extra cost : past history of local in fection, ruptured aneurysms, femoro-tibial stents, cross or axillo-fem oral revascularization for which the rate of stent infection is 6,3 - 3,2 and 1.4 %, immunodeficient patients, multiple reoperations, post-i rradiation arteritis and situations known to involve major risk of inf ection.