Dacron carotid patch infection: A report of eight cases

• Published in: Journal of vascular surgery 2000-09, Vol.32 (3), p.602-606
• Main Authors: Rizzo, Anthony, Hertzer, Norman R., O'Hara, Patrick J., Krajewski, Leonard P., Beven, Edwin G.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Blood Vessel Prosthesis; Endarterectomy, Carotid; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Neurosurgery; Polyethylene Terephthalates; Prosthesis-Related Infections - diagnostic imaging; Prosthesis-Related Infections - surgery; Radiography; Reoperation; Skull, brain, vascular surgery; Staphylococcal Infections - diagnostic imaging; Staphylococcal Infections - surgery; Streptococcal Infections - diagnostic imaging; Streptococcal Infections - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Veins - transplantation
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1067/mva.2000.107567

From 1995 through 1998, we encountered eight patients with infected Dacron patches after previous carotid endarterectomy. Two of the original operations had been done elsewhere, but the six patients who were collected from our own series represented 0.5% of the 1258 carotid endarterectomies we performed and 1.8% of the 340 synthetic carotid patches we applied without any comparable infections among another 918 patients who received either vein patch angioplasty (n = 843) or primary arteriotomy closure (n = 74) during the same 4-year study period. With a single exception (“no growth”), bacterial cultures that were obtained at the time of the eight reoperations revealed Staphylococcus (n = 4) or Streptococcus (n = 3) species. All of the infected Dacron patches were removed and were replaced with saphenous vein patches (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 nerve injuries, 1 myocardial infarction, and 1 stroke that was related to preoperative 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). (J Vasc Surg 2000;32:602-6.)