Author(s): Catarina-Ferreira, Maria ; Thierstein, Lourenço ; Pereira-Neves, António ; Rocha-Neves, João ; Araújo-Andrade, Leonardo
Date: 2025
Origin: Portuguese Journal of Cardiac Thoracic and Vascular Surgery
Subject(s): vascular graft infection; femoropopliteal bypass; prosthetic vascular graft; peripheral artery disease; postoperative complications
Introduction: Peripheral artery disease, a manifestation of systemic atherosclerosis, often necessitates surgical revascularization in advanced stages, with femoropopliteal bypass serving as a primary intervention to restore adequate lower limb perfusion. When autologous vein grafts are not available, prosthetic conduits are commonly used. However, these heterologous materials carry an increased risk of infectious complications, which, although rare, are associated with substantial morbidity and mortality. This study aims to review the current literature on prosthetic graft infections in femoropopliteal bypass surgeries, focusing on epidemiology, risk factors, microbiology, diagnostic methods, treatment strategies, and preventive measures. Materials and methods: A narrative review of the literature was conducted using databases such as PubMed to identify relevant studies on vascular prosthetic infections, particularly in femoropopliteal bypass surgeries. Results: Prosthetic graft infections occur in approximately 2.6% of femoropopliteal bypass surgeries. Staphylococcus epidermidis is the most commonly isolated pathogen. Other relevant Gram-positive bacteria include Staphylococcus aureus, and Gram-negative bacteria such as Pseudomonas aeruginosa. Accurate identification of the etiological agent through microbiological and diagnostic methods is essential for improving clinical outcomes. Early diagnosis is crucial to enable timely and effective treatment, which generally combines antibiotic therapy with surgical intervention, often necessitating graft removal. Furthermore, adopting preventive measures, such as perioperative antibiotic prophylaxis, is fundamental to reducing the incidence of these complications and minimizing the morbidity and mortality associated with prosthetic graft infections. Conclusion: Prosthetic graft infections in femoropopliteal bypass surgeries remain a challenging complication. A multidisciplinary approach encompassing early detection, evidence-based treatment, and targeted prevention strategies is essential to improve outcomes, preserve limb function, and mitigate long-term morbidity.
