Neoaortoiliac System (NAIS) Procedure for the Treatment of the Infected Aortic Graft

Chung, Jayer; Clagett, G. Patrick

doi:10.1053/j.semvascsurg.2011.10.012

Cited by 72 publications

(54 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Aortic reconstruction with FV grafts was first introduced in 1993 by Clagett et al 12) and Nevelsteen et al 13) The reported 30-day mortality rate is less than 10%, with a 5-year survival rate of 50%-60% and a 5-year limb salvage rate of about 90%. 14,15) The reinfection rate is below 2%, 16) indicating that reconstruction with the FV grafts is the most effective method of preventing reinfection. The…”

Section: Disclosure Statementmentioning

confidence: 99%

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Yamamoto

Igari

Toyofuku

et al. 2017

ATCS

View full text Add to dashboard Cite

An arterioenteric fistula is a devastating and life-threatening condition that requires urgent treatment. Less-invasive endovascular treatment has emerged as an alternative to conventional open repair, but postoperative graft infection remains a major concern. We herein report a case of late stent graft infection after emergency endovascular repair of a secondary iliac artery-enteric fistula. The patient was a 63-year-old male who presented with a fever, who had undergone successful endovascular stent grafting for a secondary common iliac artery-enteric fistula 29 months prior. The diagnosis of a stent graft infection was confirmed via computed tomography. He underwent graft removal and in situ reconstruction with femoral vein grafts. At 6-month follow-up, the patient is in a good general condition without any symptoms.

show abstract

Section: Disclosure Statementmentioning

confidence: 99%

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Yamamoto

Igari

Toyofuku

et al. 2017

ATCS

View full text Add to dashboard Cite

show abstract

“…Another material modality is the use of patient's superfi cial femoral vein as so-called Neoaortoiliac System (NAIS) (47). The advantage of NAIS is in its resistance to reinfection characterized by low recurrent infection (< 2 %), long-term durability with fi veyear primary patency and limb salvage between 75 and 91 %, or 89-96 %, short-term antibiotic and antithrombotic therapies and low cost.…”

Section: Treatment Optionsmentioning

confidence: 99%

Management of aortic graft infections – the present strategy and future perspectives

Treska¹,

Certík²,

Moláček³

2016

BLL

View full text Add to dashboard Cite

Aortic graft infections (AGI) are serious complications of open and endovascular types of surgery with an incidence rate of 0.6-3 %. AGI are associated with 30-60 % perioperative mortality and 40-60 % morbidity rate with limb amputation rates between 10 % and 40 %. The economic cost of AGI is substantial. At the time of aortic reconstruction, almost 90 % of patients have one or more predisposing factors for AGI. The diagnosis is based on clinical symptomatology, laboratory markers, microbial cultures, and imaging modalities. The general principle of surgical treatment lies in the removal of infected graft, debridement of infected periprosthetic tissues, and vascular reconstruction by in situ or extra-anatomic bypass with long-term antibiotic therapy. The conservative treatment is used only for selected patients with endograft infection. This review summarizes the current knowledge about the incidence, predisposing factors, etiology, diagnosis, treatment options, and prevention of aortic vascular graft and endograft infections. With the growing number of endovascular procedures we can expect more cases of infected aortic endografts in patients with severe comorbidities in the near future, where the recent radical surgical approach (graft excision, debridement, and new revascularization) cannot be used. Therefore the less invasive, sophisticated and individualized treatment strategies will have to be used in search of the best therapeutic approach to each specifi c patient (Fig. 4, Ref. 82). Text in PDF www.elis.sk.

show abstract

“…4,5 In these conditions, femoral vein grafts may be an attractive and viable option with good success rates. [6][7][8] Autologous femoral vein is resistant to infection and provides a good conduit for high-pressure aortic replacement. 8 Extra-anatomic bypasses with synthetic grafts have been performed as an alternative approach, but in the presence of septicemia, these are also susceptible to hematogenous seeding.…”

mentioning

confidence: 99%

“…[6][7][8] Autologous femoral vein is resistant to infection and provides a good conduit for high-pressure aortic replacement. 8 Extra-anatomic bypasses with synthetic grafts have been performed as an alternative approach, but in the presence of septicemia, these are also susceptible to hematogenous seeding. 9 Femoral vein conduit for the construction of a neoaorta is performed mainly for hemodynamically stable patients with either primary or secondary aortic infective disease.…”

mentioning

confidence: 99%

“…7,8 One of the major determinants between choice of techniques is total length of conduit required, which may vary with different infective causes (ie, aortobifemoral graft infection, mycotic aortic aneurysm). [8][9][10] The accompanying video is available online at http:// www.jvascsurg.org, and references to time elapsed are annotated in relation to the critical steps and technical insights for the successful conduct of this procedure. Corresponding timings of steps in the video are mentioned in the text in minutes:seconds format (00:00).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pantaloon femoral vein graft as “neoaorta” in infected aortic disease

Verma

Satish

Tripathi

2015

Journal of Vascular Surgery

View full text Add to dashboard Cite

Infected abdominal aortic disease and graft infections pose a significant challenge for the vascular surgeon. Thorough radical débridement, either preceded by extra-anatomic bypass or followed by in situ aortic replacement, is the mainstay of treatment. The role of endovascular repair by stent grafts is being increasingly described but is limited to relatively less virulent mycotic aneurysms or as a "bridging" option in sick patients with florid sepsis that necessitates eventual delayed definitive surgical management. Autologous femoral vein has been an excellent conduit for aortic bifurcation reconstruction in this setting. Although various configurations of femoral vein conduit have been described for aortobi-iliac reconstruction, an in-depth knowledge of the venous anatomy, physiology, mechanisms of "profundization," and techniques of harvest and graft preparation is essential for efficient conduct of the operation and its optimal outcomes. We review in detail these aspects of "pantaloon" femoral vein graft creation as a "neoaorta".

show abstract

Neoaortoiliac System (NAIS) Procedure for the Treatment of the Infected Aortic Graft

Cited by 72 publications

References 18 publications

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Management of aortic graft infections – the present strategy and future perspectives

Pantaloon femoral vein graft as “neoaorta” in infected aortic disease

Contact Info

Product

Resources

About