Management of infected peripheral bypass by selective partial graft removal and arterial homograft insertion - Two case reports

We present two cases of partial graft removal and cryopreserved arterial ho mograft insertion for treatment of patent axillobifemoral (AXB) polytetrafl uoroethylene (PTFE) prosthesis with infection confined only to a part of th e graft. In the first patient, infection was confined to the left inguinal site; in the second, there was a cutaneous fistula in the middle prosthetic thoracic tract. Neither patient presented signs of systemic sepsis and rad io immunological tests were positive only in a confined tract. After surger y, both patients showed early recovery and currently (mean follow-up 21-mon th) they are disease-free. Selective partial graft removal appears to give satisfactory results and may reduce the risk of complications compared with total graft removal Moreover, arterial homograft shows greater resistance to infection compared to alloplastic materials, when autologous veins are n ot available and/or not suitable.