关键词: 血管外科, 血管移植物感染, 腔内移植物感染, 致病菌, 抗感染治疗, 开放手术

Abstract: The application of vascular grafts has a history of nearly a century. Although the prophylactic use of antibiotics and sterile procedures during surgery have resulted in a low incidence of vascular graft/endovascular graft infection (VGEI), it still represents a highly lethal and challenging complication in vascular surgery due to its complexity and difficulty in diagnosis and treatment. The incidence of VGEI may vary depending on the surgical methods, surgical sites, and types of grafts, and there are also significant differences in the types of pathogenic bacteria among different regions. At the macro level, the causes of VGEI include incomplete intraoperative debridement, non-standard postoperative anti-infective treatment, decreased immune function leading to opportunistic pathogen translocation infection, and iatrogenic factors; At the micro level, the toxicity, drug resistance, and adhesion to grafts exhibited by different types and loads of pathogens also vary, making the mechanism of VGEI more complex. For a long time, the differences in diagnostic efficacy of VGEI have been caused by the varying experiences of doctors, and the MAGIC classification standardizes diagnostic criteria and improves systematicity and consistency. In terms of treatment, precise anti-infective therapy is the foundation, and thorough removal of infected lesions and necrotic tissue is the key. In the future, we hope to prevent and diagnose VGEI earlier and more accurately, and improve the prognosis of VGEI patients through more effective and minimally invasive treatment methods.

Key words: vascular surgery, vascular graft infection, endograft infection, pathogens, anti-infective therapy, open surgery