In situ bypass and extra-anatomic bypass procedures result in similar survival in patients with secondary aortoenteric fistulas

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Janko, Matthew R.Case Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA.;Care off Chung J, Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, One Baylor Plaza,BCM 390, Houston, TX 76030 USA. (författare)

In situ bypass and extra-anatomic bypass procedures result in similar survival in patients with secondary aortoenteric fistulas

Artikel/kapitelEngelska2021

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Elsevier,2021
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Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:uu-433665
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-433665URI
https://doi.org/10.1016/j.jvs.2020.04.515DOI

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Språk:engelska
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Objective: The optimal revascularization modality in secondary aortoenteric fistula (SAEF) remains unclear in the literature. The purpose of this investigation was to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients with SAEF. Methods: A retrospective, multi-institutional study of SAEF from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and operative and postoperative variables were recorded. The primary outcome was long-term mortality. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariate analyses were performed. Results: During the study period, 182 patients at 34 institutions from 11 countries presented with SAEF (median age, 72 years; 79% male). The initial aortic procedures that resulted in SAEF were 138 surgical grafts (76%) and 42 endografts (23%), with 2 unknown; 102 of the SAEFs (56%) underwent complete excision of infected aortic graft material, followed by in situ (in-line) bypass (ISB), including antibiotic-soaked prosthetic graft (53), autogenous femoral vein (neoaortoiliac surgery; 17), cryopreserved allograft (28), and untreated prosthetic grafts (4). There were 80 patients (44%) who underwent extra-anatomic bypass (EAB) with infected graft excision. Overall median Kaplan-Meier estimated survival was 319 days (interquartile range, 20-2410 days). Stratified by EAB vs ISB, there was no significant difference in Kaplan-Meier estimated survival (P = .82). In comparing EAB vs ISB, EAB patients were older (74 vs 70 years; P = .01), had less operative hemorrhage (1200 mL vs 2000 mL; P = .04), were more likely to initiate dialysis within 30 days postoperatively (15% vs 5%; P = .02), and were less likely to experience aorta-related hemorrhage within 30 days postoperatively (3% aortic stump dehiscence vs 11% anastomotic rupture; P = .03). There were otherwise no significant differences in presentation, comorbidities, and intraoperative or postoperative variables. Multivariable Cox regression showed that the duration of antibiotic use (hazard ratio, 0.92; 95% confidence interval, 0.86-0.98; P = .01) and rifampin use at time of discharge (hazard ratio, 0.20; 95% confidence interval, 0.05-0.86; P = .03) independently decreased mortality. Conclusions: These data suggest that ISB does not offer a survival advantage compared with EAB and does not decrease the risk of postoperative aorta-related hemorrhage. After repair, <50% of SAEF patients survive 10-months. Each week of antibiotic use decreases mortality by 8%. Further study with risk modeling is imperative for this population. (J Vasc Surg 2021;73:210-21.)

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Aortoenteric fistula
Aorta

Biuppslag (personer, institutioner, konferenser, titlar ...)

Woo, KarenUniv Calif Los Angeles, Ronald Reagan UCLA Med Ctr, Los Angeles, CA USA. (författare)
Hacker, Robert I.Mercy Hosp, Div Vasc Surg, Toledo, OH USA. (författare)
Baril, DonaldUniv Calif Los Angeles, Ronald Reagan UCLA Med Ctr, Los Angeles, CA USA. (författare)
Bath, JonathanUniv Missouri, Univ Hosp, Div Vasc Surg, Columbia, MO USA. (författare)
Smeds, Matthew R.St Louis Univ, SSM Hlth, Div Vasc Surg, St Louis, MO USA. (författare)
Kashyap, Vikram S.Case Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA. (författare)
Szeberin, ZoltanSemmelweis Univ, Dept Vasc Surg, Budapest, Hungary. (författare)
Magee, Gregory A.Univ Southern Calif, Keck Sch Med, Div Vasc Surg & Endovasc Therapy, Los Angeles, CA 90007 USA. (författare)
Elsayed, RamseyUniv Southern Calif, Keck Sch Med, Div Vasc Surg & Endovasc Therapy, Los Angeles, CA 90007 USA. (författare)
Wishy, AndrewUniv Calif Davis, Div Vasc Surg, Davis, CA 95616 USA. (författare)
St John, RebeccaUniv Alabama Birmingham, Div Vasc Surg & Endovasc Therapy, Birmingham, AL USA. (författare)
Beck, AdamUniv Alabama Birmingham, Div Vasc Surg & Endovasc Therapy, Birmingham, AL USA. (författare)
Farber, MarkUniv N Carolina, Sch Med, Div Vasc Surg, Chapel Hill, NC 27515 USA. (författare)
Motta, FernandoUniv N Carolina, Sch Med, Div Vasc Surg, Chapel Hill, NC 27515 USA. (författare)
Zhou, WeiUniv Arizona, Div Vasc & Endovasc Surg, Tucson, AZ USA. (författare)
Lemmon, GaryIndiana Univ, Hlth Phys Vasc Surg, Indianapolis, IN 46204 USA. (författare)
Coleman, DawnUniv Michigan, Div Vasc Surg, Michigan Med, Ann Arbor, MI 48109 USA. (författare)
Behrendt, Christian-AlexanderUniv Med Ctr Hamburg Eppendorf, Univ Heart Ctr Hamburg, Dept Vasc Med, Hamburg, Germany.;Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Sch Med, Dept Vasc Surg, Milan, Italy. (författare)
Aziz, FaisalMilton S Hershey Med Ctr, Penn State Heart & Vasc Inst, Hershey, PA USA. (författare)
Black, JamesJohns Hopkins Univ Hosp, Div Vasc Surg & Endovasc Therapy, Baltimore, MD USA. (författare)
Shutze, WilliamHeart Hosp Baylor Plano, Div Vasc Surg, Plano, TX USA. (författare)
Garrett, H. Edward, Jr.Cardiovasc Surg Clin, Memphis, TN USA. (författare)
De Caridi, GiovanniUniv Messina, Div Vasc Surg, Messina, Italy. (författare)
Liapis, Christos D.Natl & Kapodistrian Univ Athens, Dept Vasc Surg, Athens, Greece. (författare)
Geroulakos, GeorgeNatl & Kapodistrian Univ Athens, Dept Vasc Surg, Athens, Greece. (författare)
Kakisis, JohnNatl & Kapodistrian Univ Athens, Dept Vasc Surg, Athens, Greece. (författare)
Moulakakis, KonstantinosNatl & Kapodistrian Univ Athens, Dept Vasc Surg, Athens, Greece. (författare)
Kakkos, Stavros K.Univ Patras, Div Vasc Surg, Patras, Greece. (författare)
Obara, HideakiKeio Univ, Div Vasc Surg, Tokyo, Japan. (författare)
Wang, GraceUniv Penn, Div Vasc Surg & Endovasc Therapy, Philadelphia, PA 19104 USA. (författare)
Rheaume, PascalVancouver Gen Hosp, Div Vasc Surg, Vancouver, BC, Canada.;Univ British Columbia, Vancouver, BC, Canada. (författare)
Davila, VictorMayo Clin, Div Vasc Surg, Phoenix, AZ USA. (författare)
Ravin, ReidMt Sinai New York, Div Vasc & Endovasc Surg, New York, NY USA. (författare)
DeMartino, RandallMayo Clin, Div Vasc Surg & Endovasc Therapy, Rochester, MN USA. (författare)
Milner, RossUniv Chicago, Div Vasc Surg, Chicago, IL USA. (författare)
Shalhub, ShereneUniv Washington, Harborview Med Ctr, Div Vasc Surg, 325 9Th Ave, Seattle, WA 98104 USA. (författare)
Jim, JeffreyWashington Univ, Vasc Surg Sect, St Louis, MO 63110 USA. (författare)
Lee, JasonStanford Univ, Div Vasc & Endovasc Surg, Stanford, CA 94305 USA. (författare)
Dubuis, CelineStanford Univ, Div Vasc & Endovasc Surg, Stanford, CA 94305 USA. (författare)
Ricco, Jean-BaptisteCHU Poitiers, Hop Jean Bernard, Vasc Surg, Poitiers, France. (författare)
Coselli, JosephBaylor Coll Med, Dept Cardiothorac Surg, Houston, TX 77030 USA. (författare)
Lemaire, ScottBaylor Coll Med, Dept Cardiothorac Surg, Houston, TX 77030 USA. (författare)
Fatima, JavairiahMedStar Georgetown Univ Hosp, Div Vasc Surg, Washington, DC USA. (författare)
Sanford, JenniferSt Louis Univ, SSM Hlth, Div Vasc Surg, St Louis, MO USA. (författare)
Yoshida, WinstonFac Botucatu, Dept Vasc Surg, Botucatu, SP, Brazil. (författare)
Schermerhorn, Marc L.Beth Israel Deaconess Med Ctr, Div Vasc & Endovasc Surg, Boston, MA 02215 USA. (författare)
Menard, MatthewBrigham & Womens Hosp, Div Vasc & Endovasc Surg, 75 Francis St, Boston, MA 02115 USA. (författare)
Belkin, MichaelBrigham & Womens Hosp, Div Vasc & Endovasc Surg, 75 Francis St, Boston, MA 02115 USA. (författare)
Blackwood, StuartBrigham & Womens Hosp, Div Vasc & Endovasc Surg, 75 Francis St, Boston, MA 02115 USA. (författare)
Conrad, MarkMassachusetts Gen Hosp, Div Vasc & Endovasc Surg, Boston, MA 02114 USA. (författare)
Wang, LindaMassachusetts Gen Hosp, Div Vasc & Endovasc Surg, Boston, MA 02114 USA. (författare)
Crofts, SaraMassachusetts Gen Hosp, Div Vasc & Endovasc Surg, Boston, MA 02114 USA. (författare)
Nixon, ThomasMassachusetts Gen Hosp, Div Vasc & Endovasc Surg, Boston, MA 02114 USA. (författare)
Wu, TimothyRutgers State Univ, Robert Wood Johnson Med Sch, Div Vasc Surg & Endovasc Therapy, New Brunswick, NJ USA. (författare)
Chiesa, Roberto (författare)
Bose, SaideepCase Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA. (författare)
Turner, JasonCase Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA. (författare)
Moore, RyanCase Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA. (författare)
Smith, JustinCase Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA. (författare)
Ciocca, RoccoCase Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA. (författare)
Hsu, JeffreyKaiser Permanente, Div Vasc Surg, Fontana, Germany. (författare)
Czerny, MartinUniv Heart Ctr Freiburg Bad Krozingen, Dept Cardiovasc Surg, Freiburg, Germany. (författare)
Cullen, JonathanUniv Virginia, Med Ctr, Div Vasc & Endovasc Surg, Charlottesville, VA USA. (författare)
Kahlberg, AndreaUniv Vita Salute San Raffaele, San Raffaele Sci Inst, Sch Med, Dept Vasc Surg, Milan, Italy. (författare)
Setacci, CarloUniv Siena, Div Vasc & Endovasc Surg, Siena, Italy. (författare)
Joh, Jin HyunKyung Hee Univ, Div Vasc Surg, Seoul, South Korea. (författare)
Senneville, EricGustave Dron Hosp, Div Vasc Surg, Tourcoing, Portugal. (författare)
Garrido, PedroCtr Hosp Lisboa Norte, Div Vasc Surg, Lisbon, Portugal. Ohio State Univ, Wexner Med Ctr, Div Vasc Surg, Columbus, OH 43210 USA. (författare)
Sarac, Timur P.Univ Penn, Div Vasc Surg & Endovasc Therapy, Philadelphia, PA 19104 USA. (författare)
Rizzo, AnthonyUniv Penn, Div Vasc Surg & Endovasc Therapy, Philadelphia, PA 19104 USA. (författare)
Go, Michael R.Univ Penn, Div Vasc Surg & Endovasc Therapy, Philadelphia, PA 19104 USA. (författare)
Björck, MartinUppsala universitet,Kärlkirurgi(Swepub:uu)mabjo425 (författare)
Gavali, HamidUppsala universitet,Kärlkirurgi(Swepub:uu)hamga922 (författare)
Wanhainen, AndersUppsala universitet,Kärlkirurgi(Swepub:uu)anwan103 (författare)
Lawrence, Peter F.Univ Calif Los Angeles, Ronald Reagan UCLA Med Ctr, Los Angeles, CA USA. (författare)
Case Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA.;Care off Chung J, Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Michael E DeBakey Dept Surg, One Baylor Plaza,BCM 390, Houston, TX 76030 USA.Univ Calif Los Angeles, Ronald Reagan UCLA Med Ctr, Los Angeles, CA USA. (creator_code:org_t)

Sammanhörande titlar

Ingår i:Journal of Vascular Surgery: Elsevier73:1, s. 210-221.e10741-52141097-6809

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Av författaren/redakt...: Janko, Matthew R ...; Woo, Karen; Hacker, Robert I ...; Baril, Donald; Bath, Jonathan; Smeds, Matthew R ...; visa fler...; Kashyap, Vikram ...; Szeberin, Zoltan; Magee, Gregory A ...; Elsayed, Ramsey; Wishy, Andrew; St John, Rebecca; Beck, Adam; Farber, Mark; Motta, Fernando; Zhou, Wei; Lemmon, Gary; Coleman, Dawn; Behrendt, Christ ...; Aziz, Faisal; Black, James; Shutze, William; Garrett, H. Edwa ...; De Caridi, Giova ...; Liapis, Christos ...; Geroulakos, Geor ...; Kakisis, John; Moulakakis, Kons ...; Kakkos, Stavros ...; Obara, Hideaki; Wang, Grace; Rheaume, Pascal; Davila, Victor; Ravin, Reid; DeMartino, Randa ...; Milner, Ross; Shalhub, Sherene; Jim, Jeffrey; Lee, Jason; Dubuis, Celine; Ricco, Jean-Bapt ...; Coselli, Joseph; Lemaire, Scott; Fatima, Javairia ...; Sanford, Jennife ...; Yoshida, Winston; Schermerhorn, Ma ...; Menard, Matthew; Belkin, Michael; Blackwood, Stuar ...; Conrad, Mark; Wang, Linda; Crofts, Sara; Nixon, Thomas; Wu, Timothy; Chiesa, Roberto; Bose, Saideep; Turner, Jason; Moore, Ryan; Smith, Justin; Ciocca, Rocco; Hsu, Jeffrey; Czerny, Martin; Cullen, Jonathan; Kahlberg, Andrea; Setacci, Carlo; Joh, Jin Hyun; Senneville, Eric; Garrido, Pedro; Sarac, Timur P.; Rizzo, Anthony; Go, Michael R.; Björck, Martin; Gavali, Hamid; Wanhainen, Ander ...; Lawrence, Peter ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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