Dacron Patch Infection Following Carotid Endarterectomy: A Systematic Review of the Literature

Abstract Our report encompasses two cases of Dacron patch infection following carotid endarterectomy and a systematic review of the literature. Particular attention is placed on the incidence, aetiology, investigation, presentation and management dilemmas of this rare complication of carotid surgery...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 2009-02, Vol.37 (2), p.140-148
Main Authors: Knight, B.C, Tait, W.F
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Blood Vessel Prosthesis - adverse effects
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Carotid
Carotid Stenosis
Carotid Stenosis - surgery
Complication
Device Removal
Endarterectomy
Endarterectomy, Carotid - adverse effects
Endarterectomy, Carotid - instrumentation
Female
Humans
Incidence
Infection
Male
Polyethylene Terephthalates
Post-operative
Prosthesis Design
Prosthesis-Related Infections - diagnostic imaging
Prosthesis-Related Infections - etiology
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - surgery
Reoperation
Risk Factors
Stroke
Surgery
Treatment Outcome
Ultrasonography
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Summary:Abstract Our report encompasses two cases of Dacron patch infection following carotid endarterectomy and a systematic review of the literature. Particular attention is placed on the incidence, aetiology, investigation, presentation and management dilemmas of this rare complication of carotid surgery. We present all known cases of synthetic patch infection following carotid endarterectomy over the last 12 years. 14 publications have been identified totalling 77 cases of graft infection. Approximately 0.25–0.5% of all Dacron patches appear to get infected. Infection may present early or late and appears to have a bi-modal distribution depending on the presence of low- or high-grade infection. Post-operative complications especially wound haematoma is associated with the later development of infection. Most patients present with pseudoaneurysm formation, neck swelling or a draining local sinus and are infected with either Staphylococcus epidermidis or Staphylococcus aureus . Duplex ultrasound is the investigation of choice and complete excision of all infected material and arterial reconstruction with a vein patch or graft is recommended. Dacron patch infection is a rare but recognised complication of carotid surgery and knowledge of this condition is vital for vascular surgeons and other speciality surgeons to whom cases may present.
ISSN:1078-5884
1532-2165
DOI:10.1016/j.ejvs.2008.10.016