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Vascular graft infection

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Updated 2024 EACTS/STS guidelines for the management of aortic vascular graft infection.

Guidelines

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 Society of Thoracic Surgeons (STS/EACTS 2024), the European Society for Vascular Surgery (ESVS 2020), and the American Heart Association (AHA 2016).
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Diagnostic investigations

Initial evaluation: as per ESVS 2020 guidelines, 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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  • Microbiological testing

  • Diagnostic imaging

Medical management

General principles: as per EACTS/STS 2024 guidelines, consider managing patients with VGIs by a multidisciplinary team, including cardiovascular and vascular surgeons, imaging specialists, infectious diseases and microbiology specialists, in a facility with emergency access to these services.
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More topics in this section

  • Antimicrobial therapy

  • Management of supra-aortic trunk VGI

  • Management of aortic VGI, general principles

  • Management of aortic VGI, thoracic aorta

  • Management of aortic VGI, abdominal aorta

  • Management of aorto-esophageal fistula

  • Management of aorto-bronchial/pulmonary fistula

  • Management of peripheral artery VGI

  • Management of endovascular device infection

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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