In-situ Revascularisation for Patients with Aortic Graft Infection: A Single Centre Experience with Silver Coated Polyester Grafts

Batt, Michel; Jean-Baptiste, Elixène; O’Connor, Stephen; Bouillanne, P.-J.; Haudebourg, Pierre; Hassen-Khodja, Réda; Declemy, Serge; Rezvani, F

doi:10.1016/j.ejvs.2008.02.013

Cited by 98 publications

(60 citation statements)

References 20 publications

(26 reference statements)

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“…70,103,109,110 As with rifampin-bonded grafts, reinfection rates were higher with silver-coated grafts than with the use of cryopreserved arterial homografts. The major advantages of rifampin-bonded or silver-coated synthetic grafts were lower amputation rates, fewer conduit failures, lower earlier mortality rates, and the fact that they can be used in emergency surgery.…”

Section: Graft Excision and In Situ Reconstructionmentioning

confidence: 99%

“…14,83 rifampin-bonded coated or silver-coated prosthetic grafts. The use of rifampin-bonded synthetic grafts 3,8,11,14,71,106 or silver-coated grafts 70,103,109,110 has been reported. In a nonconcurrent study, Oderich and colleagues 11 clInIcal stateMents anD GuIDelInes compared outcomes in 52 patients who underwent resection of the infected portion of the vascular graft and in situ reconstruction with rifampin-bonded synthetic grafts with those of patients who underwent axillofemoral reconstruction and excision of the infected vascular graft.…”

Section: Graft Excision and In Situ Reconstructionmentioning

confidence: 99%

See 1 more Smart Citation

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Wilson¹,

Bower²,

Creager³

et al. 2016

Circulation

360

307

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The use of synthetic material for reconstructive vascular surgery was first reported during the early 1950s. Infection involving vascular graft prostheses is an infrequent but devastating complication of reconstructive vascular graft surgery and is associated with a high morbidity and, in some situations, mortality. Improvements in surgical techniques and graft design, including the use of native venous or arterial tissue, have reduced the frequency of infection and severity of complications from vascular graft infection (VGI). However, these advances have also led to more frequent vascular graft procedures occurring in a patient population with multiple underlying comorbidities that would have previously disqualified them as candidates for vascular reconstructive surgery. Underlying comorbidities, such as diabetes mellitus or immune compromise, increase the risk of infection and serious infection-related complications. The major complications of VGI include sepsis, amputation, disruption of infected anastomotic suture line with rupture or pseudoaneurysm formation, embolization of infected thrombi, reinfection of reconstructed vascular grafts, enteric fistulae to the small or large bowel, bacteremic spread of infection to other sites, and death. VGIs can be categorized broadly into those that occur in an extracavitary location, primarily in the groin or lower extremities, or in an intracavitary location, primarily within the abdomen or less commonly within the thorax. frequencyThe frequency of VGI depends on the anatomic location of the graft. The infection rate is 1.5% to 2% for most extracavitary grafts and as high as 6% with vascular grafts in the groin. [1][2][3][4][5][6][7][8][9] For intracavitary grafts, the infection rate is ≈1% to 5%. 1-6 Graft infection is most common after emergency procedures and after reoperation. [1][2][3][4]10 Aortic graft erosion or fistulous communication into the duodenum or other areas of the bowel reportedly occurs in 1% to 2% of patients after aortic reconstruction. 11,12 MicrobiologyThe microbiological cause of VGI has evolved over the years. 1 In early published studies, Staphylococcus aureus was the predominant microorganism recovered. 1,13 Improvements in surgical technique, administration of prophylactic antistaphylococcal antimicrobial therapy, and other factors have resulted in a changing microbiological epidemiology. Vascular graft surgery performed on patients with multiple underlying comorbidities and the increased frequency of emergency procedures have contributed to the changing spectrum of infection. Other factors such as changes in hospital flora, surgery in patients with complicated vascular anatomy, and multiple revisions of previous vascular surgery have resulted in a more diverse microbio- clInIcal stateMents anD GuIDelInes logical spectrum of infection, which includes multidrugresistant strains, polymicrobial infection, and Candida species. Gram-positive cocci accounts for at least two thirds of VGIs. 1,13 Infections caused by coagulase-negative staphylococ...

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Section: Graft Excision and In Situ Reconstructionmentioning

confidence: 99%

Section: Graft Excision and In Situ Reconstructionmentioning

confidence: 99%

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Wilson¹,

Bower²,

Creager³

et al. 2016

Circulation

360

307

View full text Add to dashboard Cite

show abstract

“…Three-year results are 75.1% and 80%, respectively SE<10% this method; the aortic stump bleeding which can occur as many as one third of the patients [14]. This debate is still running; Kuestner [6] and Armstrong [15] favour the extraanatomic operations; in contrast, Batt [16] argues for the in situ reconstruction. Kuestner [6] and Armstrong [15] reported low early and late mortality rates (21% and 18%), but the percentages of hemodynamically unstable patients were 30% and 13% in their studies.…”

Section: Discussionmentioning

confidence: 95%

Late outcome following open surgical management of secondary aortoenteric fistula

Bíró

Szabó

Fehérvári

et al. 2011

Langenbecks Arch Surg

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“…For chronic graft infection, where acute hemorrhage does not mandate immediate graft removal, a staged approach with revascularization and then delayed graft excision may be preferable. 2 For in situ graft replacement, a range of synthetic conduits have been trieddrifampicin-soaked Dacron, 3 silver-coated Dacron, 4 and bovine pericardial tubes. 5 Arterial cryopreserved homografts have been advocated 6 ; however, these are costly.…”

Section: Discussionmentioning

confidence: 99%

Aortic Graft Preservation by Debridement and Omental Wrapping

Jamieson

Burns

Dawson

et al. 2012

Annals of Vascular Surgery

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In-situ Revascularisation for Patients with Aortic Graft Infection: A Single Centre Experience with Silver Coated Polyester Grafts

Abstract: In-situ reconstruction with the silver graft confirms similarity with other modalities. The greatest advantage for the silver graft is its ease of use but the risk of reinfection remains significant.

Cited by 98 publications

References 20 publications

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Late outcome following open surgical management of secondary aortoenteric fistula

Aortic Graft Preservation by Debridement and Omental Wrapping

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