Outcome of Radical Surgical Treatment of Abdominal Aortic Graft and Endograft Infections Comparing Extra-anatomic Bypass with In Situ Reconstruction: A Nationwide Multicentre Study

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Outcome of Radical Surgical Treatment of Abdominal Aortic Graft and Endograft Infections Comparing Extra-anatomic Bypass with In Situ Reconstruction : A Nationwide Multicentre Study

Gavali, Hamid (författare): Uppsala universitet,Uppsala University,Uppsala Univ, Sweden,Kärlkirurgi

Mani, Kevin, 1975- (författare): Uppsala universitet,Uppsala University,Uppsala Univ, Sweden,Kärlkirurgi

Furebring, Mia (författare): Uppsala universitet,Uppsala University,Uppsala Univ, Sweden,Infektionsmedicin

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Olsson, Karl Wilhelm, 1985- (författare): Uppsala universitet,Uppsala University,Uppsala Univ, Sweden,Kärlkirurgi

Lindström, David (författare): Uppsala universitet,Uppsala University,Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden,Uppsala Univ, Sweden; Karolinska Univ Hosp, Sweden,Kärlkirurgi

Sörelius, Karl (författare): Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark,Copenhagen University Hospital,Rigshosp, Denmark; Univ Copenhagen, Denmark

Sigvant, Birgitta, 1962- (författare): Uppsala universitet,Uppsala University,Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Örebro University, Örebro, Sweden,Uppsala Univ, Sweden; Orebro Univ, Sweden,Kärlkirurgi

Gidlund, Khatereh D. (författare): Uppsala universitet,Uppsala University,Department of Surgery, Gävle County Hospital, Gävle, Sweden,Uppsala Univ, Sweden; Gavle Cty Hosp, Sweden,Kärlkirurgi

Torstensson, Gustav (författare): Department of Vascular Surgery, Helsingborg Regional Hospital, Helsingborg, Sweden,Helsingborg Reg Hosp, Sweden

Andersson, Manne (författare): Linköpings universitet,Linköping University,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden;County Hospital Ryhov, Jönköping County, Department of Surgery, Ryhov, Sweden,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Cty Hosp Ryhov, Sweden

Forssell, Claes (författare): Department of Cardiovascular Surgery, Division of Vascular Surgery, Linköping University Hospital, Linköping, Sweden,Region Östergötland, Thorax-kärlkliniken i Östergötland

Åstrand, Håkan (författare): Department of Surgery, County Hospital Ryhov, Jönköping County, Jönköping, Sweden,Cty Hosp Ryhov, Sweden

Lundström, Tobias (författare): Department of Surgery and urology, Eskilstuna Hospital, Eskilstuna, Sweden,Mälar Hospital,Eskilstuna Hosp, Sweden

Khan, Shahzad (författare): Department of Surgery, Malmö University Hospital, Lund University, Malmö, Sweden,Skåne University Hospital,Lund Univ, Sweden

Sonesson, Björn (författare): Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden,Department of Surgery, Malmö University Hospital, Lund University, Malmö, Sweden

Stackelberg, Otto (författare): Karolinska Institutet,Karolinska Institute,Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden;Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Gillgren, Peter (författare): Karolinska Institutet,Karolinska Institute,Stockholm South General Hospital,Karolinska Inst, Sweden; Soder Sjukhuset, Sweden,Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden;Department of Surgery, Södersjukhuset, Stockholm, Sweden

Isaksson, Jon (författare): Umeå University,Umeå universitet,Kirurgi,Department of Surgical and Peri-operative Sciences, Umeå University, Umeå, Sweden,Umea Univ, Sweden

Kragsterman, Björn (författare): Uppsala universitet,Uppsala University,Västmanland Hospital,Uppsala Univ, Sweden; Vasteras Hosp, Sweden,Kärlkirurgi,Department of Surgery, Västerås Central Hospital, Västerås, Sweden

Hörer, Tal M., 1971- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiothoracic and Vascular Surgery and Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Orebro Univ, Sweden; Orebro Univ, Sweden

Sadeghi, Mitra (författare): Örebro University,Orebro Univ, Sweden; Orebro Univ, Sweden,Department of Cardiothoracic and Vascular Surgery and Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

Wanhainen, Anders (författare): Uppsala universitet,Uppsala University,Umeå universitet,Kirurgi,Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden,Uppsala Univ, Sweden,Kärlkirurgi

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Saunders Elsevier, 2021
2021
Engelska.
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Saunders Elsevier. - 1078-5884 .- 1532-2165. ; 62:6, s. 918-926

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Objective: Abdominal aortic graft and endograft infection (AGI) is primarily treated by resection of the infected graft and restoration of distal perfusion through extra-anatomic bypass (EAB) or in situ reconstruction/repair (ISR). The aim of this study was to compare these surgical strategies in a nationwide multicentre retrospective cohort study.Methods: The Swedish Vascular Registry (Swedvasc) was used to identify surgically treated abdominal AGIs in Sweden between January 1995 and May 2017. The primary aim was to compare short and long term survival, as well as complications for EAB and ISR.Results: Some 126 radically surgically treated AGI patients were identified – 102 graft infections and 24 endograft infections – treated by EAB: 71 and ISR: 55 (23 neo-aorto-iliac systems, NAISs). No differences in early 30 day (EAB 81.7% vs. ISR 76.4%, p =.46), or long term five year survival (48.2% vs. 49.9%, p =.87) were identified. There was no survival difference comparing NAIS to other ISR strategies. The frequency of recurrent graft infection during follow up was similar: EAB 20.3% vs. ISR 17.0% (p =.56). Survival and re-infection rates of the new conduit did not differ between NAIS and other ISR strategies. Age ≥ 75 years (odds ratio [OR] 4.0, confidence interval [CI] 1.1 – 14.8), coronary artery disease (OR 4.2, CI 1.2 – 15.1) and post-operative circulatory complications (OR 5.2, CI 1.2 – 22.5) were associated with early death. Prolonged antimicrobial therapy (> 3 months) was associated with reduced long term mortality (HR 0.3, CI 0.1 – 0.9).Conclusion: In this nationwide multicentre study comparing outcomes of radically treated AGI, no differences in survival or re-infection rate could be identified comparing EAB and ISR.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Aortic graft infection
Extra-anatomical bypass
In situ repair
Multicentre
NAIS
Nationwide
Surgery
kirurgi
Aortic graft infection
Extra-anatomical bypass
In situ repair
Multicentre
NAIS
Nationwide

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

Artiklar i publikationen: European Journal ...

Av lärosätet: Umeå universitet; Örebro universitet; Lunds universitet; Linköpings universitet; Uppsala universitet; Karolinska Institutet

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