[The superficial femoral vein in aorto-iliac position--suitable as autogenous vascular replacement in deep prosthesis infection?].

The current standard therapy of aortic graft infection is connected with a high incidence of operative and late complications. The usefulness of autogenous tissue revascularization techniques as promising therapeutic alternatives is limited by the complexity of these procedures and by the lack of suitable donor vessels. Since several authors have shown that serious venous stasis of the donor leg does not occur after superficial femoral vein (SFV) resection, we have started to use this deep leg vein for arterial in situ reconstructions in the treatment of aortic graft infection. During the past 3 years seven patients have received autogenous SFV grafts in this way. There were no intraoperative deaths. Two critically ill patients with severe Pseudomonas sepsis and extensive retroperitoneal abscess each died on the 4th postoperative day, due to acute massive bleeding in the operating area. In all of the five survivors infection could be eradicated; only one limb had to be amputated. Mild to moderate transient swelling of the lower extremity without stasis was regularly seen after SFV resection. During follow-up one patient died of cardiac arrest 5 months postoperatively. The remaining four patients are still alive with patent SFV grafts at 6, 22, 30 and 36 months after the operation.