In Situ Revascularisation with Silver-coated Polyester Prostheses and Arterial Homografts in Patients with Aortic Graft Infection – A Prospective, Comparative, Single-centre Study

Aim: Primary outcome measures was to analyze the clinical consequence of patients who treated for infrarenal aorta synthetic graft infection ( SGI) with extra-anatomical bypass (axillobifemoral (AXF)) or in situ reconstruction (ISR). Secondary outcome measure was to show bacteriological analysis of abdominal aorta graft infection. Method: Analysis of medical records of 24 patients treated for SGI at Jordanian Royal Medical Services between June 2010 and Aug 2020 were retrospectively reviewed. For all patients, we recorded clinical features , morbidity and mortality , as well as bacteriology results, and antibiotic treatment . Result: We identified 24(3%) patients with SGI .The median follow up duration was 22 months range (8-84months). The median age was 52 years and 18 were males. An in situ prosthetic graft replacement, using rifampin-soaked polyester graft was performed in 10 patients(42%) and AXF in 14 patients((58%). The early hospital mortality rate was 4 (17 %.) owing to bowel ischemia 1 patient, 2 patients with septicemia and one patient with aortic stump blowout . There were no late procedure-related deaths during follow up period Primary patency and limb salvage rates at 3 years were 80 %(2 patients ) for ISR and 90%( 2 patients) for AXF. The incidence of graft reinfection was 10% (1 patient) for ISR and 8 %(2 patients) for AXF. Graft reinfection occurred in 3 patients (12.5%) was not associated with procedure-related death .Microbiology specimens obtained from the graft and the tissues were positive in 21 patients(88%). Poly microbial Gram-positive organisms were the most dominant bacteria found in 10 patients (42%). The mean length of hospital stay was 17 days . Conclusion: According to our study ISR and AXF is a safe and effective in treatment of aortic graft infection. Graft reinfection occurred in 12.5% of the patients. The graft patency and limb salvages rates were considered satisfactory.

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Re-resection rates and risk characteristics following breast conserving surgery for breast cancer and carcinoma in situ: A single-centre study of 1575 consecutive cases

The Breast ◽

10.1016/j.breast.2014.08.011 ◽

2014 ◽

Vol 23 (6) ◽

pp. 784-789 ◽

Cited By ~ 11

Author(s):

C.G. Kryh ◽

C.A. Pietersen ◽

H.B. Rahr ◽

R.D. Christensen ◽

P. Wamberg ◽

...

Keyword(s):

Breast Cancer ◽

Carcinoma In Situ ◽

Breast Conserving Surgery ◽

Single Centre ◽

Centre Study ◽

Risk Characteristics ◽

Single Centre Study

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Infrarenal aortic graft infection: in situ aortoiliofemoral reconstruction with the lower extremity deep veins

European Journal of Vascular and Endovascular Surgery ◽

10.1016/s1078-5884(97)80162-1 ◽

1997 ◽

Vol 14 ◽

pp. 88-92 ◽

Cited By ~ 33

Author(s):

A. Nevelsteen ◽

H. Lacroix ◽

R. Suy

Keyword(s):

Lower Extremity ◽

Graft Infection ◽

Aortic Graft ◽

Aortic Graft Infection

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Treatment for Abdominal Aortic Graft Infection: Irrigation with Electrolyzed Strong Aqueous Acid, In-situ Grafting, and Omentoplasty

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2000-8889 ◽

2000 ◽

Vol 48 (1) ◽

pp. 43-44 ◽

Cited By ~ 1

Author(s):

H. Ogino ◽

Y. Ueda ◽

T. Sugita ◽

K. Matsuyama ◽

K. Matsubayashi ◽

...

Keyword(s):

Graft Infection ◽

Aortic Graft ◽

Aqueous Acid ◽

Abdominal Aortic ◽

Aortic Graft Infection

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Contemporary management of infrarenal aortic graft infection: early and late results in 82 patients

Vascular ◽

10.1258/vasc.2011.oa0315 ◽

2012 ◽

Vol 20 (3) ◽

pp. 129-137 ◽

Cited By ~ 17

Author(s):

Michel Batt ◽

Elixène Jean-Baptiste ◽

Stephen O'Connor ◽

Patrick Feugier ◽

Stéphan Haulon

Keyword(s):

Graft Infection ◽

Late Results ◽

Treatment Modalities ◽

Anatomic Reconstruction ◽

Aortic Graft ◽

Perioperative Mortality ◽

In Situ Reconstruction ◽

Aortic Graft Infection ◽

Contemporary Management

Management of aortic graft infection (AGI) remains contentious. The purpose of this study was to evaluate factors of clinical significance which influence the outcome of different treatment modalities for AGI. From 2000 to 2008, 82 consecutive patients were treated for AGI. In situ reconstruction (ISR) was performed in 63 patients with various conduits, extra-anatomic reconstruction (EAR) in 11, conservative treatment in five and resection without reconstruction in three. The perioperative mortality rate for the series (33%) was similar for EAR and ISR and was higher in patients with secondary aortoenteric fistula ( P < 0.001) in those undergoing emergency aortic reconstruction ( P < 0.001) and in AGI caused by virulent organisms ( P < 0.05). Fifteen (27%) of the surviving patients developed a recurrence of infection (RI). EAR patients were more exposed to RI ( P < 0.04). In conclusion, ISR may be more appropriate for AGI, but this study cannot draw a conclusion relating to the optimal conduit for ISR.

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