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Department of Infectious Diseases and Hospital Epidemiology
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Department of Infectious Diseases and Hospital Epidemiology

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Vascular graft Cohort Study (VASGRA)

Vascular grafts are increasingly implanted due to an increasing prevalence of atherosclerosis and diabetes, and about 1-6% of vascular procedures are complicated by infection.

Mortality attributable to prosthetic vascular graft infections (PVGI) is high. However, there are almost no data regarding best treatment options of such complicated infections. Most recommendations are based on expert opinion and not on clinical trials or cohort observational data analyses. Evaluating infectious and other complications after vascular surgery procedures are important, and additionally, such studies may offer insights for quality improvement and improved patient outcomes.

We created a prospective observational cohort database on patients with an incident prosthetic vascular graft infection (VASGRA). Additionally, we established a biobank with the collection of tissue- and blood samples of patients.

The Vascular graft cohort study (VASGRA) is an ongoing single-center research project at the University hospital Zurich dealing with adults aged 18 years or older with an implanted vascular graft and/ or prosthetic vascular graft infection (PVGI). It was established in 2013. There is a clear separation between hospital infrastructure and research budget, implementation of a quality control programs and research by nested projects. VASGRA is supported by the Swiss National Science Foundation (SNF). Our research goals are:

Epidemiology

  • Determine the incidence and outcome of complications after vascular graft placement
  • Determine risk factors, best treatment strategies, and outcome of PVGI
  • Determine the influence of different antibiotic regimens on outcome of PVGI due to different bacterial pathogens
  • Imaging techniques
  • Determine accuracy of PET/CT in the assessment of treatment response in PVGI
  • Determine accuracy of MRI, angio-CT and PET/CT for the diagnosis of PVGI

Microbiology

  • Determine the bacterial diversity of vascular wounds using broad range PCR
  • Determine the impact of negative pressure wound therapy on bacterial
  • diversity in PVGI using broad range PCR

Biomarkers

  • Determine cut-off levels of blood leucocytes count, ESR, CRP and
  • procalcitonin raising suspicion of a PVGI

Histopathology

Evaluate histopathological features of tissue and excised vascular grafts

Basic Research

  • In a collaboration with the Laboratory of Prof Dr. A. Zinkernagel we will examine whether antibiotics interfering with protein synthesis affect bacterial biofilm formation.

Collaborators

  • Prof. Dr. Annelies Zinkernagel, Divicion of Infectious Diseases and Hospital Epidemiology, USZ
  • Prof. B. Ledergerber, Division of Infectious Diseases and Hospital Epidemiology, USZ
  • Prof. Dr. Lars Husmann, Clinic for Nuclear Medicine, USZ
  • PD Dr. med Martin Hüllner, Clinic for Nuclear Medicine, USZ
  • PD Dr. Ewerton Marques Maggio, Insitute of Surgical Pathology, USZ
  • PD Dr. Zoran Rancic, Clinic for vascular surgery, USZ
  • Dr. R. Kopp, Clinic for vascular surgery, USZ
  • Dr. M. Hofmann, Clinic for vascular surgery, USZ
  • Prof. Dr. Alexander Zimmermann, Clinic for vascular surgery, USZ
  • Prof. Dr. med. Benedikt Reutersberg, Clinic for vascular surgery, USZ