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Vascular stent graft infection

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https://www.readbyqxmd.com/read/28948487/how-to-treat-aortic-graft-infection-with-a-special-emphasis-on-xeno-pericardial-aortic-tube-grafts
#1
Thierry Carrel, Lars Englberger, Jürg Schmidli
Infection of a vascular prosthesis or endovascular stent-graft is probably the most serious complication that may occur after implantation and dramatically affects the patient's outcome. The most common etiology of graft and/or prosthetic valve infection is usually wound-related infection, followed by seeding from distant infection sites (lung, urinary tract). Surgical treatment is almost always required but even after surgery, morbidity can be significant. Operative procedure must be tailored according to the individual patient and to the experience of the surgical team...
September 25, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28856325/ilioprofunda-endobypass-can-successfully-treat-a-post-operative-femoral-pseudo-aneurysm
#2
T Mehta, R Dey, A Chaudhuri
INTRODUCTION: A 75-year-old male patient with significant cardiopulmonary comorbidity presented with a 70-mm left femoral pseudoaneurysm 6 years after aortobifemoral bypass (and prior femoral endarterectomy). REPORT: As the left superficial femoral artery was occluded, an ilioprofunda endobypass was undertaken following extraperitoneal exposure of the left limb of the bypass graft with subsequent deployment of four Viabahn endoprostheses via the left limb into the proximal left deep femoral artery with successful exclusion of the pseudoaneurysm...
2017: EJVES Short Rep
https://www.readbyqxmd.com/read/28762638/principles-of-treating-enlarging-pseudoaneurysm-in-a-dialysis-arteriovenous-graft
#3
Daniel V Patel, Tushar J Vachharajani
The arteriovenous graft (AVG) is one of the major types of permanent vascular access used to provide hemodialysis. Complications encountered with AVG use include stenosis, infection, thrombosis, and pseudoaneurysm formation. Venous outflow stenosis along with frequent needle cannulation at the same site can lead to breakdown of the graft material, resulting in pseudoaneurysm formation. In the following case, we illustrate common management principles used to treat pseudoaneurysms. While stent-grafts have been utilized for pseudoaneurysm repair, stent-graft usage is not always optimal...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28715360/contemporary-management-of-subclavian-and-axillary-artery-injuries-a-western-trauma-association-multicenter-review
#4
Christine J Waller, Thomas H Cogbill, Kara J Kallies, Luis D Ramirez, Justin M Cardenas, S Rob Todd, Kayla J Chapman, Marshall A Beckman, Jason L Sperry, Vincent P Anto, Evert A Eriksson, Stuart M Leon, Rahul J Anand, Maura Pearlstein, Lisa Capano-Wehrle, Clay Cothren Burlew, Charles J Fox, Daniel C Cullinane, Jennifer C Roberts, Paul B Harrison, Gina M Berg, James M Haan, Kelly Lightwine
BACKGROUND: Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. METHODS: A multicenter, retrospective review of patients with subclavian or axillary artery injuries from 1/1/2004-12/31/2014 was completed at 11 participating Western Trauma Association institutions...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#5
MULTICENTER STUDY
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28255132/extra-anatomical-veno-venous-surgical-bypass-for-central-vein-occlusion-in-patients-with-ipsilateral-arterio-venous-fistula-avf-for-haemodialysis-a-single-centre-experience
#6
K S Saravana, A A Zainal
OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face. MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28018510/spontaneous-evacuation-of-a-vascular-metallic-stent-through-a-graft-duodenal-fistula-with-concomitant-non-surgical-fistula-closure
#7
Shunya Shindo, Hidenori Inoue, Shinya Motohashi, Hirotomo Uchiyama, Junetsu Akasaka
We report a patient who developed ileus caused by vascular stent migration into the duodenum with periprosthetic retroperitoneal abscess. The patient previously underwent removal of an infected abdominal aortic aneurysm with concomitant axillobifemoral arterial reconstruction. An occlusion of the graft leg was treated by a unilateral aortoiliac bypass where endovascular surgery with a metallic stent was later needed. The abscess and ileus were vigorously drained. Following the spontaneous evacuation of the metallic stent via the digestive tract, the abscess was completely drained and fistula closure was achieved without surgical intervention...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28004900/current-management-of-inguinal-false-aneurysms
#8
REVIEW
Kim Houlind, Jørn M Jepsen, Cristian Saicu, Sten Vammen, Johnny K Christensen, Hans Ravn
False aneurysms are formed as a result of bleeding causing a hematoma to compress the surrounding tissue. The majority of false aneurysms presenting to the vascular surgeon are caused by iatrogenic injury to an artery. Although anastomotic failure occurs, a much higher number is caused by bleeding from puncture sites after percutaneous intervention. Anticoagulative medication, low patelet counts and severely calcified vessels increase the risk of forming a false aneurysm. Experienced specialists may make the diagnosis from physical examination, but ultrasound imaging is almost always needed in order to decide for a treatment strategy...
April 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27925869/endovascular-management-of-infected-iliofemoral-pseudoaneurysms-a-systematic-review
#9
REVIEW
Konstantinos G Moulakakis, Vangelis G Alexiou, George S Sfyroeras, John Kakisis, Andreas Lazaris, Spyridon N Vasdekis, Elias N Brountzos, George Geroulakos
We conducted a systematic review regarding the efficacy and outcome of endovascular treatment of infected iliofemoral arterial pseudoaneurysms with covered stents. 35 cases were identified, including 5 own. 22 pseudoaneurysms were located in the femoral area and 13 in the iliac vessels. The most commonly reported complaints were pulsatile groin mass (40 %), sepsis (37.1 %), active bleeding (31.4 %), and groin infection with purulent discharge (17.1 %). S. aureus (65.7 %) and Streptococcus species (22.9 %) were the most common microbes isolated...
January 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27799273/nationwide-study-of-the-treatment-of-mycotic-abdominal-aortic-aneurysms-comparing-open-and-endovascular-repair
#10
Karl Sörelius, Anders Wanhainen, Mia Furebring, Martin Björck, Peter Gillgren, Kevin Mani
BACKGROUND: No reliable comparative data exist between open repair (OR) and endovascular aneurysm repair (EVAR) for mycotic abdominal aortic aneurysms (MAAAs). This nationwide study assessed outcomes after OR and EVAR for MAAA in a population-based cohort. METHODS: All patients treated for MAAAs in Sweden between 1994 and 2014 were identified in the Swedish vascular registry. The primary aim was to assess survival after MAAA with OR and EVAR. Secondary aims were analyses of the rate of recurrent infections and reoperations, and time trends in surgical treatment...
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27771318/diagnosis-of-aortic-graft-infection-a-case-definition-by-the-management-of-aortic-graft-infection-collaboration-magic
#11
O T A Lyons, M Baguneid, T D Barwick, R E Bell, N Foster, S Homer-Vanniasinkam, S Hopkins, A Hussain, K Katsanos, B Modarai, J A T Sandoe, S Thomas, N M Price
OBJECTIVE/BACKGROUND: The management of aortic graft infection (AGI) is highly complex and in the absence of a universally accepted case definition and evidence-based guidelines, clinical approaches and outcomes vary widely. The objective was to define precise criteria for diagnosing AGI. METHODS: A process of expert review and consensus, involving formal collaboration between vascular surgeons, infection specialists, and radiologists from several English National Health Service hospital Trusts with large vascular services (Management of Aortic Graft Infection Collaboration [MAGIC]), produced the definition...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27768661/direct-site-endovascular-repair-dser-a-novel-approach-to-vascular-trauma
#12
Anders J Davidson, Lucas P Neff, Joseph J DuBose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow but require additional vascular intervention and risk shunt thrombosis with prolonged use...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27602890/direct-site-endovascular-repair-dser-a-novel-approach-to-vascular-trauma
#13
Anders J Davidson, Lucas P Neff, Joseph J Dubose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow, but require additional vascular intervention and risk shunt thrombosis with prolonged use...
September 16, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27545033/-management-of-endo-graft-infection-following-endovascular-repair-of-abdominal-aortic-aneurysm
#14
H H Yin, M Wang, Z L Li, C Yao, Z J Hu, J S Wang, G Q Chang, S M Wang
OBJECTIVE: To summarize our experience in the management of stent-graft infection after endo-vascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA). METHODS: Data of patients who were diagnosed as endo-graft infection following EVAR and admitted in our center between January 2000 and December 2015 were reviewed. Clinical records including causes of infection, medical history, re-operative procedures, and prognostic data were analysed. RESULTS: A total of 10 male patients, aged 45-72 years (averaged 62...
August 9, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27462000/contemporary-comparison-of-aortofemoral-bypass-to-alternative-inflow-procedures-in-the-veteran-population
#15
COMPARATIVE STUDY
James T McPhee, Arin Madenci, Joseph Raffetto, Michelle Martin, Naren Gupta
OBJECTIVE: Multiple vascular inflow reconstruction options exist for claudication, including aortofemoral bypass (AFB) and alternative inflow procedures (AIPs) such as femoral reconstruction with iliac stents, and femoral-femoral, iliofemoral, and axillofemoral bypass. Contemporary multi-institution comparison of these techniques is lacking. METHODS: The Veterans Affairs Surgical Quality Improvement Project (VASQIP) national database (2005-2013) was used to compare AFB vs AIP in a propensity-matched analysis...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27321981/the-readmission-event-after-vascular-surgery-causes-and-costs
#16
COMPARATIVE STUDY
Yazan Duwayri, Jonathan Goss, William Knechtle, Ravi K Veeraswamy, Shipra Arya, Ravi R Rajani, Luke P Brewster, Thomas F Dodson, John F Sweeney
BACKGROUND: The study evaluates the readmission diagnoses after vascular surgical interventions and the associated hospital costs. METHODS: Patients readmitted after undergoing carotid artery stenting (CAS), carotid endarterectomy (CEA), infrarenal endovascular abdominal aortic aneurysm repair (EVAR), open abdominal aortic aneurysm repair (OAAA), suprainguinal revascularization (SUPRA), or infrainguinal revascularization (INFRA) between January 1, 2008 and October 20, 2013 at a single academic institution were retrospectively identified...
October 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26994956/late-single-center-outcome-of-the-talent-abdominal-stent-graft-after-a-decade-of-follow-up
#17
Yannick W 't Mannetje, Pieter P H L Broos, Roy F A van Poppel, Marc R H M van Sambeek, Joep A W Teijink, Philippe W M Cuypers
OBJECTIVE: Lifelong yearly surveillance is advised after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. This follow-up requires a substantial amount of health care resources. The aim of this paper was to assess the occurrence of stent graft-related complications and secondary interventions during a minimum 10-year follow-up after elective EVAR. METHODS: Patients who were treated in a high-volume endovascular center in The Netherlands with the Talent infrarenal stent graft (Medtronic Vascular, Santa Rosa, Calif) between June 1999 and February 2005 were included...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26986706/inflammatory-diseases-of-the-aorta
#18
REVIEW
Ludwig Caspary
Inflammatory aortic diseases may occur with and without dilatation and are complicated by obstruction, rupture and dissection. Infections originate from periaortic foci or septicaemia and tend to result in the rapid development of aneurysms. Large vessel vasculitis due to Takayasu arteritis in younger and giant cell arteritis (GCA) in older patients is located in all layers of the aortic wall and prevails in the thoracic section. GCA patients are prone to developing aortic complications in the late course of disease...
January 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/26944600/editor-s-choice-long-term-outcome-after-endovac-hybrid-repair-of%C3%A2-infected-vascular-reconstructions
#19
K Thorbjørnsen, K Djavani Gidlund, M Björck, B Kragsterman, A Wanhainen
OBJECTIVE/BACKGROUND: Vascular graft infection is a serious and challenging complication. In situations when neither traditional radical surgery nor conservative negative pressure wound therapy (VAC) alone, are considered feasible or safe, for example due to bleeding, adverse anatomy, or severe comorbidity, a novel hybrid procedure was developed. The EndoVAC technique consists of (i) relining of the infected reconstruction with a stent graft; (ii) surgical revision (without clamping the reconstruction); and (iii) VAC therapy, to permit granulation and secondary delayed healing, and long-term antibiotic treatment...
May 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26120019/pantaloon-femoral-vein-graft-as-neoaorta-in-infected-aortic-disease
#20
Himanshu Verma, Satish Mohan, Ramesh K Tripathi
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...
October 2015: Journal of Vascular Surgery
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