Dacron carotid patch infection: A report of eight cases

From 1995 through 1998, we encountered eight patients with infected Dacron patches after previous carotid endarterectomy. Two of the original operatio ns had been done elsewhere, but the six patients who were collected from ou r own series represented 0.5% of the 1258 carotid endarterectomies we perfo rmed and 1.8% of the 340 synthetic carotid patches we applied without any c omparable infections among another 918 patients who received either vein pa tch angioplasty (n = 843) or primary arteriotomy closure (n = 74) during th e same 4-year study period. With a single exception ("no growth"), bacteria l cultures that were obtained at the time of the eight reoperations reveale d Staphylococcus (n = 4) or Streptococcus (n = 3) species. All of the infec ted Dacron patches were removed and were replaced with saphenous vein patch es (n = 5) or interposition grafts (n = 3), after which appropriate oral (n = 2) or intravenous (n = 6) antibiotics were administered for 2 to 6 weeks . No postoperative deaths occurred, but there were 2 temporary cranial nerv e injuries, 1 myocardial infarction, and 1 stroke that was related to preop erative angiography. A recurrent carotid infection has not developed in any of the eight patients during a mean follow-up interval of 16 months (range , 3-36 months).