Surgical and medical interventions for abdominal aortic graft infections

Niaz, Osamah; Rao, Ahsan; Abidia, A; Parrott, Rebecca; Refson, Jonathan; Somaiya, Pranav

doi:10.1002/14651858.cd013469.pub2

Cited by 4 publications

(3 citation statements)

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“…4,5 The therapy 1 Unit of Vascular and Endovascular Surgery, Azienda Ospedaliero Universitaria di Ferrara -Arcispedale S.Anna, Ferrara, Italy for this event is variable, depending on the surgeon experience and patient clinical conditions. 4,6 COVID-19, a viral infection initially thought to be prominently an interstitial pneumonia, 7,8 can be considered as a vascular disease with regards to serious complications and mortality. Quite recently, blood clots have emerged as the common factor unifying many of the symptoms currently without an apparent explanation.…”

Section: Introductionmentioning

confidence: 99%

“…However, AEF can lead itself to a secondary graft infection. 4,5 The therapy for this event is variable, depending on the surgeon experience and patient clinical conditions. 4,6…”

Section: Introductionmentioning

confidence: 99%

“…4,5 The therapy for this event is variable, depending on the surgeon experience and patient clinical conditions. 4,6…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 induced aorto duodenal fistula following evar in the so called “negative” patient

et al. 2021

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Objectives Since October 2019, SARS-CoV-2 pandemic represents a challenge for the international healthcare system and for the treatment and survival of patients. We normally focus on symptomatic patients, and symptoms can range from the respiratory to the gastrointestinal system. In addition, we consider patients without fever and respiratory symptoms, with both a negative RT nasopharyngeal swab and lung CT, as a “Covid-19 negative patient.” In this article, we present a so called Covid-19 “negative” patient, with an unsuspected vascular clinical onset of the viral infection. Methods An 80 y.o. man, who previously underwent endovascular aortic repair for an infrarenal abdominal aortic aneurysm, presented to our department with an atypical presentation of an aorto-enteric fistula during the pandemic. While in hospital, weekly nasopharyngeal swab tests were always negative for SARS-CoV-2. However, the absence of aortic endograft complications, the gross anatomy of duodenal ischemic injury, and the recent history of the patient who lived the last months in Bergamo, the Italian city with the highest number of COVID-19 deaths, lead the senior Author to suspect an occult SARS-CoV-2 infection. The patient underwent to resection of the fourth portion of the duodenum and the first jejunal loop, with subsequent duodenum–jejunal latero-lateral anastomosis and the direct suture of the aortic wall. The intestinal specimen was investigated as suspected SARS-CoV-2 bowel infection by the means of immune-histochemistry (IHC). An ileum sample obtained in the pre-COVID-19 era was used as a control tissue. Results The histological analysis of the bowel revealed sustained wall ischemia and liponecrosis of the duodenal wall, with intramural blood vessels thrombosis. Blood vessel endotheliitis and neo-angiogenesis were also observed. Finally, the IHC was strongly positive for SARS-CoV-2 RNA and for HLA-G presence, with a particular concentration both in blood vessels and in the intestinal villi. The control tissue sample was not positive for both SARS-CoV-2 and HLA-G. Conclusions Coronavirus pandemic continues to be an international challenge and more studies and trials must be done to learn its pathogenesis and its complications. As for thromboembolic events caused by SARS-COV-2, vascular surgeons are involved in treatment and prevention of the complications of this syndrome and must be ready with general surgeons to investigate atypical and particular cases such as the one discussed in this article.

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Section: Introductionmentioning

confidence: 99%

“…However, AEF can lead itself to a secondary graft infection. 4,5 The therapy for this event is variable, depending on the surgeon experience and patient clinical conditions. 4,6…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 induced aorto duodenal fistula following evar in the so called “negative” patient

et al. 2021

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Surgical and medical interventions for abdominal aortic graft infections

Niaz

Rao

Abidia

et al. 2020

Cochrane Database of Systematic Reviews

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Radiometal chelators for infection diagnostics

Akter

Lyons²,

Mehra³

et al. 2023

Front. Nucl. Med.

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wInfection of native tissues or implanted devices is common, but clinical diagnosis is frequently difficult and currently available noninvasive tests perform poorly. Immunocompromised individuals (for example transplant recipients, or those with cancer) are at increased risk. No imaging test in clinical use can specifically identify infection, or accurately differentiate bacterial from fungal infections. Commonly used [18F]fluorodeoxyglucose (18FDG) positron emission computed tomography (PET/CT) is sensitive for infection, but limited by poor specificity because increased glucose uptake may also indicate inflammation or malignancy. Furthermore, this tracer provides no indication of the type of infective agent (bacterial, fungal, or parasitic). Imaging tools that directly and specifically target microbial pathogens are highly desirable to improve noninvasive infection diagnosis and localization. A growing field of research is exploring the utility of radiometals and their chelators (siderophores), which are small molecules that bind radiometals and form a stable complex allowing sequestration by microbes. This radiometal-chelator complex can be directed to a specific microbial target in vivo, facilitating anatomical localization by PET or single photon emission computed tomography. Additionally, bifunctional chelators can further conjugate therapeutic molecules (e.g., peptides, antibiotics, antibodies) while still bound to desired radiometals, combining specific imaging with highly targeted antimicrobial therapy. These novel therapeutics may prove a useful complement to the armamentarium in the global fight against antimicrobial resistance. This review will highlight current state of infection imaging diagnostics and their limitations, strategies to develop infection-specific diagnostics, recent advances in radiometal-based chelators for microbial infection imaging, challenges, and future directions to improve targeted diagnostics and/or therapeutics.

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Surgical and medical interventions for abdominal aortic graft infections

Cited by 4 publications

References 50 publications

COVID-19 induced aorto duodenal fistula following evar in the so called “negative” patient

COVID-19 induced aorto duodenal fistula following evar in the so called “negative” patient

Surgical and medical interventions for abdominal aortic graft infections

Radiometal chelators for infection diagnostics

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