Open or Endovascular Repair of Aortoenteric Fistulas? A Multicentre Comparative Study

Kakkos, Stavros K.; Antoniadis, Pavlos; Klonaris, Chris; Papazoglou, Konstantinos; Giannoukas, Athanasios D.; Matsagkas, Miltiadis; Kotsis, Thomas; Dervisis, Konstantinos; Gerasimidis, Thomas; Tsolakis, Ioannis A.; Liapis, Christos D.

doi:10.1016/j.ejvs.2010.12.026

Cited by 86 publications

(57 citation statements)

References 20 publications

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“…But several reports later described contradictory outcomes with the development of recurrent hemorrhage or persistent infection in more than 40% of the patients and mortality rate in more than 30 % of cases (76,77). These data support the strategy of using endovascular repair only as a bridge option allowing defi nitive repair at a later time after optimization of the patient's condition.…”

Section: Treatment Optionsmentioning

confidence: 54%

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

Treska¹,

Certík²,

Moláček³

2016

BLL

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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.

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Section: Treatment Optionsmentioning

confidence: 54%

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

Treska¹,

Certík²,

Moláček³

2016

BLL

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“…This difference had disappeared after two years because of excess recurrent disease in the EVAR group. The authors conclude that EVAR might be used in the future as a bridge to definitive repair (Kakkos et al, 2011) …”

Section: Aortoenteric Fistulamentioning

confidence: 99%

“…Diagnosis is confirmed with gastroduodenoscopy and CT angiography. Despite prompt open repair, secondary aortoenteric fistula remains a very lethal condition with mortality rates up to 50% (Kakkos, 2011). A small series buy Kuestner et al described extra-anatomic bypass followed a few days thereafter by graft removal.…”

Section: Aortoenteric Fistulamentioning

confidence: 99%

Late Complications Following Aortic Aneurysm Repair

Zeeland¹,

Laan²

2011

Diagnosis, Screening and Treatment of Abdominal, Thoracoabdominal and Thoracic Aortic Aneurysms

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“…In a report by Kakkos et al,6) no in-hospital deaths were observed after endovascular repair of AEFs, but the in-hospital mortality rate was 35% after open repair. Despite the short-term benefits, sepsis and recurrent bleeding generally worsened the 2-year overall survival rate in the endovascular repair group (24%) compared with the open repair group (50%).…”

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

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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.

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Open or Endovascular Repair of Aortoenteric Fistulas? A Multicentre Comparative Study

Cited by 86 publications

References 20 publications

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

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

Late Complications Following Aortic Aneurysm Repair

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

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