Use of superficial femoropopliteal vein for suprainguinal arterial reconstruction in the presence of infection

Background: Conventional treatment of mycotic aneurysms or graft infections of the aortoiliac segment by in situ or extra-anatomic prosthetic reconstr uction has a high mortality and morbidity rate, with a substantial risk of persistent graft infection. The use of autologous vein may reduce this. Methods: Eleven patients with suprainguinal arterial infections including t wo with mycotic aortic aneurysms, four with aortic graft infections, four i nfected femorofemoral grafts and an infected axillofemoral graft were treat ed by debridement and in situ reconstruction with autologous superficial fe moropopliteal vein. All patients received appropriate antibiotic therapy an d were followed by regular postoperative duplex imaging. Preoperative femor al vein duplex imaging was performed in eight of the 11 patients. Results: Ten of the 11 patients survived with a functioning graft and witho ut limb loss or evidence of infection at 4-33 months. One patient died from myocardial infarction after operation. Three patients had minor swelling o f one leg. Four patients required subsequent angioplasty of anastomotic ste noses detected by duplex surveillance. Conclusion: Superficial femoropopliteal vein is an excellent conduit for su prainguinal reconstruction in the presence of infection. Duplex imaging is useful for confirming the suitability of deep veins for use as a graft and for postoperative surveillance.