The vascular surgical procedure to replace infected aortic grafts with the body's own veins has been found to be more durable by the UT Southwestern Medical Center, but also less vulnerable to new infection than other such techniques using synthetic and cadaver grafts.
Aortic graft infections are one of the most serious complications developed by patients going through aortic grafting procedures for peripheral arterial disease (PAD) and aortic aneurysms.
PAD lessens blood circulation in the pelvis and lower extremities, and aortic aneurysms result in a weakening of the aortic wall that can lead to a dangerous rupture of the aorta, the largest artery in the body.
Surgery is often necessary for patients with PAD and aortic aneurysms and usually aortic grafting procedures that make use of synthetic grafts are done.
This restores blood circulation to the legs of PAD patients and for patients with aneurysm it replaces the weak aortic wall and prevents it from rupture. However synthetic grafts placed in the aorta and femoral arteries can get infected and this may cause amputation and even death if left untreated.
Dr. G. Patrick Clagett, chief of vascular surgery at UT Southwestern, broke new ground by developing a technique called the neo-aortoiliac system (NAIS) that takes care of these aortic-graft infections. The infected graft are removed replaced with sections of femoral-popliteal veins taken from the patient's thighs, instead of another synthetic graft or vessels harvested from human cadavers.
In a recent study that appears in the Journal of Vascular Surgery, Dr. Clagett and his colleagues reported on 187 patients, who underwent the NAIS procedure for aortic graft infections from 1990 to 2006 at UT Southwestern.
Researchers saw that re-infection was less and the procedure resulted in superior durability with significantly lower long-term amputation rates when compared with other techniques to treat this condition.
Dr. Clagett said: "This operation has gained favor worldwide in the treatment of this devastating condition.... Since performing the first operation here in the 1990s, we have accumulated data over the years and have found this procedure to be far superior in overall patient outcomes."
He added: "When we use the patient's own tissue to construct a new graft, it provides an advantage because they are less likely to form clots within the graft and less likely to develop new blockages.... Patients also need fewer subsequent procedures, a common problem with the other treatments for this complication."