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Vascular graft infection

Key sources
The following summarized guidelines for the evaluation and management of vascular graft infection are prepared by our editorial team based on guidelines from the European Society for Vascular Surgery (ESVS 2020) and the American Heart Association (AHA 2016).
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Guidelines

1.Diagnostic investigations

Initial evaluation: obtain comprehensive evaluation of clinical status, signs of infection and patient comorbidities according to the MAGIC criteria in patients with suspected VGI.
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  • Microbiologic testing

  • Diagnostic imaging

2.Medical management

General principles: as per ESVS 2020 guidelines, transfer patients to a specialized high volume center with multidisciplinary experience in this pathology for the diagnosis and treatment of VGI.
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  • Antibiotic therapy

  • Management of supra-aortic trunk VGI

  • Management of thoracic aorta VGI

  • Management of aorto-esophageal fistula

  • Management of aorto-bronchial/pulmonary fistula

  • Management of abdominal aorta VGI

  • Management of peripheral artery VGI

  • Management of endovascular device infection

3.Preventative measures

Antibiotic prophylaxis: as per ESVS 2020 guidelines, administer an IV first- or second-generation cephalosporin, or vancomycin in the event of penicillin allergy, as antimicrobial prophylaxis to cover the first 24 hours in all patients with an implanted vascular graft/endograft.
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