A case against immediate revascularisation after uni- or bilateral removal of infected aortobifemoral (end-to-side) prosthetic grafts. Report based on three cases.

More than 75% of the infections of Dacron aortobifemoral grafts occur in the groin. Early removal of the infected limb will enable the vascular surgeon to leave the abdominal part and opposite limb of the graft in place. In aortoiliac occlusive disease and with end-to-side proximal and distal anastomoses, simple removal of the infected graft will not threaten the viability of the limb. Complicated and often incomplete extra-anatomical revascularisation is therefore not necessary and consequently operative time and risk are reduced. Close pre- and postoperative monitoring of the peripheral circulation and painstaking decubitus prophylaxis are mandatory. After 3 to 6 months "in situ" bypass can be performed to correct claudication. Three patients that have been successfully treated according to this philosophy are presented.