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• W4234927128 abstract "This study examined the medical and surgical management and outcomes of patients with abdominal (EVAR) or thoracic (TEVAR) aortic endograft infection. Patients diagnosed with infected aortic endografts after EVAR/TEVAR between January 1, 2004, and January 1, 2014, were reviewed using a standardized, multi-institutional database. Demographic, comorbidity, medical management, surgical, and outcomes data were included. An aortic endograft infection was diagnosed in 202 patients (EVAR, 176; TEVAR, 26) a mean of 716 days after implant. Symptoms included pain (54%), fever/chills (47%), and weight loss (20%). Twenty-nine patients were initially managed medically with antibiotics; 21 ultimately underwent surgical management after a mean of 86 days. In situ aortic replacement was performed in 183 patients (91%; Dacron, 46; Cryoartery, 47; polytetrafluoroethylene [PTFE], 36; Dacron soaked in antibiotic, 26; NAIS, 21; Cryovein, 7), and 11 underwent axillary-(bi)femoral bypass with PTFE. Graft cultures were primarily polymicrobial and fungal. Mean hospital length of stay was 24 days with early complications of renal failure in 37, persistent sepsis in 24, myocardial infarction in 9, recurrent infection in 9, and pneumonia in 8. Perioperative 30-day mortality was 11%. Nineteen replacement grafts were explanted after a mean of 540 days, and were most commonly associated with Dacron graft material not soaked in antibiotic (P < .05); persistent sepsis was associated with both Dacron and PTFE grafts (P < .05). Mean follow-up was 20 months, with life-table survival and graft-related mortality estimates of 56% and 23%, respectively, at 5 years (Fig). Aortic endograft infection can be eradicated by excision and in situ or extra-anatomic replacement but is often associated with early postoperative morbidity and mortality and occasionally a need for late removal for reinfection. Prosthetic graft replacement after explanation is associated with higher reinfection and graft-related complications." @default.
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• W4234927128 date "2015-06-01" @default.
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• W4234927128 title "SS1. Treatment and Outcomes of Aortic Endograft Infection" @default.
• W4234927128 doi "https://doi.org/10.1016/j.jvs.2015.04.071" @default.
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