In vivo construction of a multilayer bare-metal stent for the treatment of an aortic mycotic pseudoaneurysm

Kahn, S. Lowell; Peeran, Syed; Smolinski, Sara; Norris, Marc A.; Rhee, Sang Won; Kaufman, Jeffrey L.

doi:10.1016/j.jvs.2014.02.010

Cited by 3 publications

(3 citation statements)

References 14 publications

(40 reference statements)

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“…In patients not suitable for conventional open surgery, an infection aortic PSA may be possible to be managed by endovascular treatment. [3,5,6] However, it could trouble endovascular procedure for complex aortic PSA involving visceral arteries. Based on our results, the hybrid procedure is a possible alternative to open surgery or endovascular repair.…”

Section: Discussionmentioning

confidence: 99%

“…A multilayer bare-metal stent for the treatment of an aortic infection PSA was recently reported for protecting visceral artery patency with multilayer bare-metal stents; in addition, the theoretic advantage is absence of graft fabric that could provide a platform for bacterial colonization. [5,6] Because the multilayer stent is not available in the China, we designed for surgical reconstruction for the visceral arteries.…”

Section: Discussionmentioning

confidence: 99%

“…The criteria concerning the length of antibiotic therapy following the PSA treatment were not clear (Table 1), [3,5,6,10] but the long-time continued antibiotic therapy should be executed for infection PSA in our center. The clinical signs of infection were absent, and once the antibiotic stopped by patient himself during follow-up, the recurrent infection was detected.…”

Section: Discussionmentioning

confidence: 99%

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Hybrid repair for a complex infection aortic pseudoaneurysm with continued antibiotic therapy

Chen

Yuan²,

Zhao³

et al. 2019

Medicine

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Introduction: Treatment of infection aortic pseudoaneurysm (PSA) is a great challenge to surgeons for 3 reasons: high mortality for rupture or threatened rupture; potential risk for infection of prosthetic material which probably bring a devastating result for patients; and long-term antibiotic therapy requirement. Endovascular repair is an alternative to open surgery for a less invasive, which is a trouble procedure for aortic PSA with complex aortic anatomy. The purpose of this article is to report the novel hybrid repair of an infection aortic PSA and antibiotics therapy. Clinical finding: A 61-year-old man with complaints of repeated abdominal pain and fever for 3 months was admitted. He had a fever of 39.0°C and normal blood pressure. The blood leukocyte count was 14.9 × 10 9 /L, C-reactive protein was 132 mg/L. There was no evidence for urinary tract infection. The small effusion was identified in bilateral thoracic cavity and pelvis cavity, and the severe lung function impairment was detected. Klebsiella pneumoniae was identified in blood cultures. Computer tomographic (CT) angiography showed a 6 cm × 6 cm aortic PSA involving bilateral renal arteries and a subhepatic inflammatory mass (identified by percutaneous puncture). Diagnosis: According to the symptoms, CT and lab test, the main diagnosis for this patient were: infective aortic PSA involving bilateral renal arteries, and Bacteremia with K pneumoniae. Intervention and outcomes: A hybrid procedure combined open surgical and endovascular was performed for managing the paravisceral infection aortic PSA in a 61-year-old man with high risk. To decrease the risk of graft infection, autologous saphenous vein graft was adopted, and long-term antibiotic therapy was used. At 2 years follow-up, the patient was in good clinical condition with continued antibiotic therapy. Conclusion: Hybrid procedure is an alternative approach according to high risk patients with complex anatomy for open repair of infection aortic PSA. The postoperative long-time continued antibiotic therapy must be emphasized for infection PSA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hybrid repair for a complex infection aortic pseudoaneurysm with continued antibiotic therapy

Chen

Yuan²,

Zhao³

et al. 2019

Medicine

View full text Add to dashboard Cite

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Hemodynamic Effects of Multiple Overlapping Uncovered Stents on Aortic Dissection: Surgical Strategies and Implications for False Lumen Thrombosis

Dai

Luo

Dai

et al. 2019

Cardiovasc Eng Tech

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Endovascular treatment of complicated aortic aneurysms using a modified flow-diverting strategy: Mid- to long-term outcome from a multicenter cohort study

Zhang

et al. 2022

BJR

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Objectives: Frequently reported adverse events following flow-diverting stents’ treatment of aortic aneurysms indicate further refinements of this technique are required. This study aims at evaluating the clinical efficacy of an improved flow-diverting strategy. Methods: A modified flow-diverting procedure was utilized in selected patients, in which stent-grafts were used to cover the non-branched segment of the aneurysmal lesion while flow-diverting multilayered bare metal stents were applied to cover the reno-visceral segment. The safety and efficacy of this joint procedure were assessed by regular follow-up. Results: We screened 497 patients and included 67 cases (mean age: 67.07 ± 12.14 years; 53 males) between February 2012 and March 2018. The median number of stent-grafts and bare metal stents used in the procedure were 1 (range: 1 to 3) and 3 (range: 2 to 4), respectively. During a mean follow-up period of 34.54 ± 20.28 months, aneurysm maximum diameter decreased from 64.79 ± 10.31 to 59.32 ± 10.20 mm (p = 0.002), while sac thrombosis ratio increased from 26.01±10.99% to 98.46±4.84% (p<0.001). Aneurysm-related death or conversion to open repair was documented in three patients. The majority side-branches (198/201) remained patent during follow-up. Overall clinical success rate reached 91.04% (61/67). Conclusions: The joint procedure is characterized by significant aneurysm thrombosis along with high aneurysm stabilization/shrinkage and side-branches’ patency rate. It might represent a potential improvement of the flow-diverting strategy in treating complex aortic lesions, yet large-scale, prospective, and randomized trials are anticipated to draw a robust conclusion. Advances in knowledge: The joint procedure could potentially exclude complex aortic aneurysms from circulation while maintaining the collateral branches.

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In vivo construction of a multilayer bare-metal stent for the treatment of an aortic mycotic pseudoaneurysm

Cited by 3 publications

References 14 publications

Hybrid repair for a complex infection aortic pseudoaneurysm with continued antibiotic therapy

Hybrid repair for a complex infection aortic pseudoaneurysm with continued antibiotic therapy

Hemodynamic Effects of Multiple Overlapping Uncovered Stents on Aortic Dissection: Surgical Strategies and Implications for False Lumen Thrombosis

Endovascular treatment of complicated aortic aneurysms using a modified flow-diverting strategy: Mid- to long-term outcome from a multicenter cohort study

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