Infected prosthetic arteriovenous grafts for hemodialysis present a profound risk to patient well being. Here we present five recent cases and describe our technique for total graft excision. We also review the literature and discuss the much debated role of partial, subtotal, and total graft excision.
SchildA F., SimonS., PrietoJ., RainesJ.Single-center review of infections associated with 1,574 consecutive vascular access procedures. Vasc Endovascular Surg2003; 37: 27–31.
5.
US Renal Data Systems: USRDS2003Annual Data Report: Atlas of End-Stage Renal Disease in the United States, Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.
6.
HoenB., Paul-DauphinA., HestinD., KesslerM.EPIBACDIAL: a multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients. J Am Soc Nephrol1998; 9: 869–76.
7.
PoweN.R., JaarB., FurthS.L.Septicemia in dialysis patients: incidence, risk factors, and prognosis. Kidney Int1999; 55: 1081–90.
8.
PooleC.V., CarltonD., BimboL., AllonM.Treatment of catheter-related bacteraemia with an antibiotic lock protocol: effect of bacterial pathogen. Nephrol Dial Transplant2004; 19: 1237–44.
9.
MarrK.A., KongL., FowlerV.G.Incidence and outcome of Staphylococcus aureus bacteremia in hemodialysis patients. Kidney Int1998; 54: 1684–9.
10.
InrigJ.K., ReedS.D., SzczechL.A.Relationship between clinical outcomes and vascular access type among hemodialysis patients with Staphylococcus aureus bacteremia. Clin J Am Soc Nephrol2006; 1: 518–24.
11.
NassarG.M., AyusJ.C.Infectious complications of the hemodialysis access. Kidney Int2001; 60: 1–13.
12.
CalligaroK.D., VeithF.J., GuptaS.K.A modified method for management of prosthetic graft infections involving an anastomosis to the common femoral artery. J Vasc Surg1990; 11: 485–92.
13.
CalligaroK.D., VeithF.J., DoughertyM.J., DeLaurentisD.A.Management and outcome of infrapopliteal arterial graft infections with distal graft involvement. Am J Surg1996; 172: 178–80.
