A 14-year Experience with Aortic Endograft Infection: Management and Results

Lyons, Oliver; Patel, Alpesh; Saha, Prakash; Clough, Rachel E.; Price, Nick; Taylor, Peter R.

doi:10.1016/j.ejvs.2013.04.021

Cited by 91 publications

(76 citation statements)

References 37 publications

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“…17 A 69-year-old man underwent thrombectomy and balloon angioplasty of a thrombosed right graft limb. 4 Figure^Study flow chart. …”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, no data for infection recurrence were available. In the report by Lyons et al, 4 the 10 patients with infected endografts treated with explantation and axillobifemoral bypass had a 30% mortality. As noted above, the 3 patients treated conservatively died: the first in the hospital and the remaining 2 at 3 and 5 months, respectively.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Outcome After Preservation of Infected Abdominal Aortic Endografts

Moulakakis

Sfyroeras

Mylonas

et al. 2014

Journal of Endovascular Therapy

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Among patients treated for endograft infection without explantation, those with aortoenteric fistula had the worst outcome. There is evidence for lower mortality in patients who underwent an additional procedure, such as drainage, surgical debridement, and sac irrigation. Larger studies are needed to examine the efficacy of this approach compared to surgical conversion with endograft excision and in situ reconstruction or extra-anatomical bypass.

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“…17 A 69-year-old man underwent thrombectomy and balloon angioplasty of a thrombosed right graft limb. 4 Figure^Study flow chart. …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Outcome After Preservation of Infected Abdominal Aortic Endografts

Moulakakis

Sfyroeras

Mylonas

et al. 2014

Journal of Endovascular Therapy

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“…Even with very high dosage and very long duration, antibiotherapy alone is not supposed to cure PVGIs [152]. For instance, a recent study dealing with aortic endograft infection demonstrated that all of the patients who did not undergo endograft removal died during follow-up [49].…”

Section: Rationalementioning

confidence: 98%

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

Revest¹,

Camou²,

Senneville³

et al. 2015

International Journal of Antimicrobial Agents

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More than 400000 vascular grafts are inserted annually in the USA. Graft insertion is complicated by infection in 0.5-4% of cases. Vascular graft infections (VGIs) are becoming one of the most frequent prosthesis-related infections and are associated with considerable mortality, ranging from 10 to 25% within 30 days following the diagnosis. Treatment of VGI is based on urgent surgical removal of the infected graft followed by prolonged antibiotherapy. Data regarding the best antibiotherapy to use are lacking since no well designed trial to study antimicrobial treatment of VGI exists. Moreover, since VGIs demonstrate very specific pathophysiology, guidelines on other material-related infections or infective endocarditis treatment cannot be entirely applied to VGI. A French multidisciplinary group gathering infectious diseases specialists, anaesthesiologists, intensivists, microbiologists, radiologists and vascular surgeons was created to review the literature dealing with VGI and to make some proposals regarding empirical and documented antibiotic therapy for these infections. This article reveals these proposals.

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“…3 Variable incidences have been reported in the current literature ranging from 0.05% to 4%. [5][6][7] Endograft infection can be complicated by rupture, aortoenteric fistulization, and sepsis.…”

Section: Discussionmentioning

confidence: 92%

“…1 Surgical removal of the graft with revascularization is the preferred management option, 2 although 30-day mortality has been quoted as high as 30%. 3 Removal of endograft devices has been documented to be notoriously difficult because of hooked barbs that implant into the aortic wall, removal of which can lead to injury. 4 We report a variation not previously described for resheathing of the device, allowing safe removal, with a disposable proctoscope.…”

mentioning

confidence: 99%

A new technique to explant an infected aortic endograft

Popplewell

Garnham

Hobbs

2015

Journal of Vascular Surgery

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The management of an infected aortic endograft can be challenging both operatively and clinically. Although aortic endograft infection is rare, the incidence is likely to increase in the coming years because of ever rising numbers of endovascular aneurysm repairs. Definitive management involves the removal of the endograft through laparotomy. Removal of the graft is technically challenging; no manufacturer's device is available to assist in disengagement of barbed hooks that hold the endograft in position. We present a new technique using the disposable proctoscope as a device to facilitate safe removal of the endograft with minimal damage to the aortic wall.

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A 14-year Experience with Aortic Endograft Infection: Management and Results

Abstract: Abdominal endograft explantation is high risk but may be curative. Appropriate selection of patients for infected endograft explantation remains a major challenge.

Cited by 91 publications

References 37 publications

Outcome After Preservation of Infected Abdominal Aortic Endografts

Outcome After Preservation of Infected Abdominal Aortic Endografts

Medical treatment of prosthetic vascular graft infections: Review of the literature and proposals of a Working Group

A new technique to explant an infected aortic endograft

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