Infection involving an aortic prosthesis is among the most challenging
diagnostic and therapeutic complications in vascular surgery. Delays
in diagnosis and treatment are associated with decreased patient survi
val. Graft excision and revascularization by an extra-anatomic route o
r autogenous repair is associated with a mortality of 15% to 20% and a
n amputation rate of less than 10%. Carefully selected patients with l
ate-appearing infection caused by Staphylococcus epidermidis can be sa
fely treated by in situ graft replacement. Early diagnosis, coupled wi
th surgical intervention that eradicates the infectious process, are k
ey elements for successful treatment. In the majority of patients, lon
g-term survival, free of infection, is possible but requires careful s
urveillance for persistent or recurrent infection.