Abdominal aortic endograft infection. A decade of experience and literature review

Dominguez-Cainzos, Jokin; Rodrigo-Manjon, Alejandro; Rodriguez-Chinesta, Jose Manuel; Apodaka-Diez, Ana; Bonmatí, Gonzalo; Bereciartúa, Elena

doi:10.1016/j.eimce.2022.07.002

Cited by 1 publication

(2 citation statements)

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“…1 ). The characteristics of the included studies and clinical characteristics of the study populations are presented in Table 1 [ 6 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 ]. A total of 873 patients were included; 176 patients after EVAR in 8 studies, 473 patients after OSR in 13 studies, and 168 patients after EVAR or OSR in 2 studies.…”

Section: Resultsmentioning

confidence: 99%

“…In studies that reported outcomes with graft preservation, additional or secondary procedures were performed. For initial treatment the following procedures were performed, aneurysmorrhaphy with omentum patching (n = 1) [ 32 ], EVAR (n = 1) [ 15 ], irrigation with omental or bovine patch (n = 2) [ 20 ], and percutaneous drainage (n = 7) [ 25 ]. Secondary procedures were performed in 2 studies; EVAR in a patient with rupture during antibiotics treatment (n = 1) [ 15 ] and complete graft removal with anatomic bypass (n = 2) or EAB (n = 2), percutaneous drainage (n = 1) or graft retention with EAB (n = 1) [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

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Clinical outcome of graft removal versus preservation in abdominal aortic graft infection: a systematic review and meta-analysis

Kim,

Choi,

Kwon

et al. 2023

Ann Surg Treat Res

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Purpose The purpose of this study was to compare the clinical outcomes of abdominal aortic graft infection (AGI) treated with removal of the graft vs. graft preservation. Methods The electronic databases PubMed, Embase, and Cochrane Library for studies that reported on AGI were searched. Observational studies and case series of at least 10 cases that reporting on the prevalence, microbiology, and outcomes of AGI were included. Results Our search identified 23 studies that met our inclusion criteria, reporting on a total of 873 patients who underwent open surgical repair (OSR) or endovascular aneurysm repair (EVAR). Of these patients, 833 received graft removal, and 40 received graft preservation. The prevalence of AGI was reported to be 1.0% (95% confidence interval [CI], 0.5%–1.8%) after OSR and 0.4% (95% CI, 0%–1.1%) after EVAR. The pooled estimates of 1-year, 2-year, and 5-year mortality were 28.7% (95% CI, 19.4%–38.8%), 36.6% (95% CI, 24.6%–49.5%), and 51.8% (95% CI, 38.4%–65.1%) in the graft removal group and 16.1% (95% CI, 4.1%–32.2%), 18.5% (95% CI, 5.7%–35.1%), and 50.0% (95% CI, 31.6%–68.4%) in the graft preservation group. The 30-day mortality rate’s risk ratio (RR) for graft removal vs. preservation was 0.98 (95% CI, 0.40–2.38), while the 1-year mortality rate’s RR was 3.44 (95% CI, 1.60–7.42). Conclusion The 30-day mortality rate of AGI treatment was found to be high, whether using graft removal or preservation. In selected patients, implementing antibiotics with graft preservation as an initial management may be helpful in reducing the mortality rate.

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