In-situ bypass is associated with superior infection-free survival compared with extra-anatomic bypass for the management of secondary aortic graft infections without enteric involvement

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Fältnamn	Indikatorer	Metadata
000		12361naa a2201201 4500
001		oai:DiVA.org:uu-482791
003		SwePub
008		220830s2022 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4827912 URI
024	7	a https://doi.org/10.1016/j.jvs.2022.03.8692 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Janko, Matthew R.u Case Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA.4 aut
245	1 0	a In-situ bypass is associated with superior infection-free survival compared with extra-anatomic bypass for the management of secondary aortic graft infections without enteric involvement
264	1	b Elsevier,c 2022
338		a print2 rdacarrier
520		a Objective: The optimal revascularization modality following complete resection of aortic graft infection (AGI) without enteric involvement remains unclear. The purpose of this investigation is to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients undergoing complete excision of AGI. Methods: A retrospective, multi-institutional study of AGI from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and perioperative variables were recorded. The primary outcome was infection-free survival. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariable analyses were performed. Results: A total of 241 patients at 34 institutions from seven countries presented with AGI during the study period (median age, 68 years; 75% male). The initial aortic procedures that resulted in AGI were 172 surgical grafts (71%), 66 endografts (27%), and three unknown (2%). Of the patients, 172 (71%) underwent complete excision of infected aortic graft material followed by in situ (in-line) bypass (ISB), including antibiotic-treated prosthetic graft (35%), autogenous femoral vein (neo-aortoiliac surgery) (24%), and cryopreserved allograft (41%). Sixty-nine patients (29%) underwent extra-anatomic bypass (EAB). Overall median Kaplan-Meier estimated survival was 5.8 years. Perioperative mortality was 16%. When stratified by ISB vs EAB, there was a significant difference in Kaplan-Meier estimated infection-free survival (2910 days; interquartile range, 391-3771 days vs 180 days; interquartile range, 27-3750 days; P <.001). There were otherwise no significant differences in presentation, comorbidities, or perioperative variables. Multivariable Cox regression showed lower infection-free survival among patients with EAB (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.6-3.6; P <.001), polymicrobial infection (HR, 2.2; 95% CI, 1.4-3.5; P = .001), methicillin-resistant Staphylococcus aureus infection (HR, 1.7; 95% CI, 1.1-2.7; P = .02), as well as the protective effect of omental/muscle flap coverage (HR, 0.59; 95% CI, 0.37-0.92; P = .02). Conclusions: After complete resection of AGI, perioperative mortality is 16% and median overall survival is 5.8 years. EAB is associated with nearly a two and one-half-fold higher reinfection/mortality compared with ISB. Omental and/or muscle flap coverage of the repair appear protective.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
653		a Antibiotic-soaked Dacron
653		a Aortic graft infection
653		a Axillofemoral bypass
653		a Cryopreserved allograft
653		a Extra-anatomic bypass
653		a In situ bypass
653		a Neo-aortoiliac surgery (NAIS)
700	1	a Hubbard, Grantu Case Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA.4 aut
700	1	a Back, Martinu Univ Florida, Dept Surg, Div Vasc Surg, Gainesville, FL USA.4 aut
700	1	a Shah, Samir K.u Univ Florida, Dept Surg, Div Vasc Surg, Gainesville, FL USA.4 aut
700	1	a Pomozi, Enikou Semmelweis Univ, Dept Vasc & Endovasc Surg, Budapest, Hungary.4 aut
700	1	a Szeberin, Zoltanu Semmelweis Univ, Dept Vasc & Endovasc Surg, Budapest, Hungary.4 aut
700	1	a DeMartino, Randallu Mayo Clin, Div Vasc & Endovasc Surg, Rochester, MN USA.4 aut
700	1	a Wang, Linda J.u Massachusetts Gen Hosp, Dept Vasc & Endovasc Surg, Boston, MA 02114 USA.4 aut
700	1	a Crofts, Sarahu Massachusetts Gen Hosp, Dept Vasc & Endovasc Surg, Boston, MA 02114 USA.4 aut
700	1	a Belkin, Michaelu Harvard Med Sch, Brigham & Womens Hosp, Dept Vasc & Endovasc Surg, Boston, MA 02115 USA.4 aut
700	1	a Davila, Victor J.u Mayo Clin Arizona, Div Vasc Surg, Dept Gen Surg, Phoenix, AZ USA.4 aut
700	1	a Lemmon, Gary W.u Indiana Univ, Dept Surg, Div Vasc Surg, Indianapolis, IN USA.4 aut
700	1	a Wang, Shihuan K.u Indiana Univ, Dept Surg, Div Vasc Surg, Indianapolis, IN USA.4 aut
700	1	a Czerny, Martinu Univ Heart Ctr Freiburg Bad Krozingen, Dept Cardiovasc Surg, Freiburg, Germany.4 aut
700	1	a Kreibich, Maximilianu Univ Heart Ctr Freiburg Bad Krozingen, Dept Cardiovasc Surg, Freiburg, Germany.4 aut
700	1	a Humphries, Misty D.u UC Davis Hlth, Div Vasc Surg, Dept Surg, Sacramento, CA USA.4 aut
700	1	a Shutze, Williamu Heart Hosp Plano, Texas Vasc Associates, Plano, TX USA.4 aut
700	1	a Joh, Jin Hyunu Kyung Hee Univ Hosp Gangdong, Dept Surg, Div Vasc Surg, Seoul, South Korea.4 aut
700	1	a Cho, Sungsinu Univ Med Ctr Hamburg Eppendorf, Dept Vasc Med, GermanVasc Res Grp, Hamburg, Germany.4 aut
700	1	a Behrendt, Christian-Alexanderu Univ Med Ctr Hamburg Eppendorf, Dept Vasc Med, GermanVasc Res Grp, Hamburg, Germany.4 aut
700	1	a Setacci, Carlou Univ Siena, Dept Vasc & Endovasc Surg, Siena, Italy.4 aut
700	1	a Hacker, Robert, Iu Surg Arts St Louis, Div Vasc Surg, Bridgeton, MO USA.4 aut
700	1	a Sobreira, Marcone Limau Univ Estadual Paulista, Botucatu Sch Med, Dept Surg & Orthoped, Sao Paulo, Brazil.4 aut
700	1	a Yoshida, Winston Bonettiu Univ Estadual Paulista, Botucatu Sch Med, Dept Surg & Orthoped, Sao Paulo, Brazil.4 aut
700	1	a D'Oria, Mariou Univ Hosp Trieste, Cardiovasc Dept, Div Vasc & Endovasc Surg, Trieste, Italy.4 aut
700	1	a Lepidi, Sandrou Univ Hosp Trieste, Cardiovasc Dept, Div Vasc & Endovasc Surg, Trieste, Italy.4 aut
700	1	a Chiesa, Robertou Ist Sci San Raffaele, Dept Vasc Surg, Milan, Italy.4 aut
700	1	a Kahlberg, Andreau Ist Sci San Raffaele, Dept Vasc Surg, Milan, Italy.4 aut
700	1	a Go, Michael R.u Ohio State Univ, Coll Med, Dept Surg, Div Vasc Dis & Surg, Columbus, OH 43210 USA.4 aut
700	1	a Rizzo, Anthony N.u Ohio State Univ, Coll Med, Dept Surg, Div Vasc Dis & Surg, Columbus, OH 43210 USA.4 aut
700	1	a Black, James H.u Johns Hopkins Univ Hosp, Div Vasc Surg & Endovasc Therapy, Dept Surg, Baltimore, MD 21287 USA.4 aut
700	1	a Magee, Gregory A.u Univ Southern Calif, Dept Surg, Div Vasc Surg & Endovasc Therapy, Los Angeles, CA USA.4 aut
700	1	a Elsayed, Ramseyu Univ Southern Calif, Dept Surg, Div Vasc Surg & Endovasc Therapy, Los Angeles, CA USA.4 aut
700	1	a Baril, Donald T.u Cedars Sinai Med Ctr, Dept Surg, Div Vasc Surg, Los Angeles, CA 90048 USA.4 aut
700	1	a Beck, Adam W.u Univ Alabama Birmingham, Div Vasc Surg & Endovasc Therapy, Birmingham, AL USA.4 aut
700	1	a McFarland, Graeme E.u Univ Alabama Birmingham, Div Vasc Surg & Endovasc Therapy, Birmingham, AL USA.4 aut
700	1	a Gavali, Hamidu Uppsala universitet,Institutionen för medicinsk cellbiologi,Science for Life Laboratory, SciLifeLab,Kärlkirurgi4 aut0 (Swepub:uu)hamga922
700	1	a Wanhainen, Andersu Uppsala universitet,Kärlkirurgi4 aut0 (Swepub:uu)anwan103
700	1	a Kashyap, Vikram S.u Case Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA.4 aut
700	1	a Stoecker, Jordan B.u Hosp Univ Penn, Dept Surg, Div Vasc Surg & Endovasc Therapy, 3400 Spruce St, Philadelphia, PA 19104 USA.4 aut
700	1	a Wang, Grace J.u Hosp Univ Penn, Dept Surg, Div Vasc Surg & Endovasc Therapy, 3400 Spruce St, Philadelphia, PA 19104 USA.4 aut
700	1	a Zhou, Weiu Univ Arizona, Dept Surg, Div Vasc Surg, Tucson, AZ USA.4 aut
700	1	a Fujimura, Naokiu Keio Univ, Dept Surg, Sch Med, Shinjuku Ku, Tokyo, Japan.4 aut
700	1	a Obara, Hideakiu Brooke Army Med Ctr, Div Vasc & Endovasc Surg, San Antonio, TX USA.4 aut
700	1	a Wishy, Andrew M.u St Louis Univ, Div Vasc Surg, Dept Surg, St Louis, MO USA.4 aut
700	1	a Bose, Saideepu St Louis Univ, Div Vasc Surg, Dept Surg, St Louis, MO USA.4 aut
700	1	a Smeds, Matthewu Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Vasc & Endovasc Surg, Boston, MA 02115 USA.4 aut
700	1	a Liang, Patricu Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Vasc & Endovasc Surg, Boston, MA 02115 USA.4 aut
700	1	a Schermerhorn, Marcu St Elizabeth Hosp, Div Vasc Surg, Brighton, MA USA.4 aut
700	1	a Conrad, Mark F.u Kaiser Permanente, Div Vasc Surg, Fontana, CA USA.4 aut
700	1	a Hsu, Jeffrey H.u Kaiser Permanente, Div Vasc Surg, Fontana, CA USA.4 aut
700	1	a Patel, Rhusheetu Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Vasc Surg & Endovasc Therapy, Los Angeles, CA 90095 USA.4 aut
700	1	a Lee, Jason T.u Stanford Univ, Med Ctr, Dept Surg, Div Vasc Surg, Stanford, CA 94305 USA.4 aut
700	1	a Liapis, Christos D.u Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Dept Vasc Surg, Athens, Greece.4 aut
700	1	a Moulakakis, Konstantinos G.u Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Dept Vasc Surg, Athens, Greece.4 aut
700	1	a Farber, Mark A.u Univ N Carolina, Dept Surg, Div Vasc Surg, Chapel Hill, NC USA.4 aut
700	1	a Motta, Fernandou Univ N Carolina, Dept Surg, Div Vasc Surg, Chapel Hill, NC USA.4 aut
700	1	a Ricco, Jean-Baptisteu Univ Poitiers Med Sch, Dept Clin Res, Poitiers, France.4 aut
700	1	a Bath, Jonathanu Univ Missouri, Cardiovasc Surg Clin, Columbia, MO USA.4 aut
700	1	a Coselli, Joseph S.u Baylor Coll Med, Michael E DeBakey Dept Surg, Div Cardiothorac Surg, Houston, TX 77030 USA.4 aut
700	1	a Aziz, Faisalu Penn State Hlth Heart & Vasc Inst, Div Vasc Surg, Hershey, PA USA.4 aut
700	1	a Coleman, Dawn M.u Univ Michigan, Dept Surg, Sect Vasc Surg, Ann Arbor, MI 48109 USA.4 aut
700	1	a Davis, Frank M.u Univ Michigan, Dept Surg, Sect Vasc Surg, Ann Arbor, MI 48109 USA.4 aut
700	1	a Fatima, Javairiahu Georgetown Univ, MedStar Heart & Vasc Inst, Washington, DC USA.4 aut
700	1	a Irshad, Aliu Tufts Univ, Sch Med, Cardiovasc Ctr Tufts Med Ctr, Boston, MA 02111 USA.4 aut
700	1	a Shalhub, Shereneu Univ Washington, Sch Med, Dept Surg, Div Vasc Surg, Seattle, WA 98195 USA.4 aut
700	1	a Kakkos, Stavrosu Univ Patras, Dept Vasc Surg, Med Sch, Patras, Greece.4 aut
700	1	a Zhang, Qianziu Baylor Coll Med, Michael E DeBakey Dept Surg, Div Vasc & Endovasc Therapy, One Baylor Plaza,BCM 390, Houston, TX 77030 USA.4 aut
700	1	a Lawrence, Peter F.u Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Vasc Surg & Endovasc Therapy, Los Angeles, CA 90095 USA.4 aut
700	1	a Woo, Karenu Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Vasc Surg & Endovasc Therapy, Los Angeles, CA 90095 USA.4 aut
700	1	a Chung, Jayeru Baylor Coll Med, Michael E DeBakey Dept Surg, Div Vasc & Endovasc Therapy, One Baylor Plaza,BCM 390, Houston, TX 77030 USA.4 aut
710	2	a Case Western Reserve Univ, Sch Med, Univ Hosp Cleveland Med Ctr, Div Vasc Surg & Endovasc Therapy, Cleveland, OH 44106 USA.b Univ Florida, Dept Surg, Div Vasc Surg, Gainesville, FL USA.4 org
773	0	t Journal of Vascular Surgeryd : Elsevierg 76:2, s. 546-q 76:2<546-x 0741-5214x 1097-6809
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-482791
856	4 8	u https://doi.org/10.1016/j.jvs.2022.03.869

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Av författaren/redakt...: Janko, Matthew R ...; Hubbard, Grant; Back, Martin; Shah, Samir K.; Pomozi, Eniko; Szeberin, Zoltan; visa fler...; DeMartino, Randa ...; Wang, Linda J.; Crofts, Sarah; Belkin, Michael; Davila, Victor J ...; Lemmon, Gary W.; Wang, Shihuan K.; Czerny, Martin; Kreibich, Maximi ...; Humphries, Misty ...; Shutze, William; Joh, Jin Hyun; Cho, Sungsin; Behrendt, Christ ...; Setacci, Carlo; Hacker, Robert, ...; Sobreira, Marcon ...; Yoshida, Winston ...; D'Oria, Mario; Lepidi, Sandro; Chiesa, Roberto; Kahlberg, Andrea; Go, Michael R.; Rizzo, Anthony N ...; Black, James H.; Magee, Gregory A ...; Elsayed, Ramsey; Baril, Donald T.; Beck, Adam W.; McFarland, Graem ...; Gavali, Hamid; Wanhainen, Ander ...; Kashyap, Vikram ...; Stoecker, Jordan ...; Wang, Grace J.; Zhou, Wei; Fujimura, Naoki; Obara, Hideaki; Wishy, Andrew M.; Bose, Saideep; Smeds, Matthew; Liang, Patric; Schermerhorn, Ma ...; Conrad, Mark F.; Hsu, Jeffrey H.; Patel, Rhusheet; Lee, Jason T.; Liapis, Christos ...; Moulakakis, Kons ...; Farber, Mark A.; Motta, Fernando; Ricco, Jean-Bapt ...; Bath, Jonathan; Coselli, Joseph ...; Aziz, Faisal; Coleman, Dawn M.; Davis, Frank M.; Fatima, Javairia ...; Irshad, Ali; Shalhub, Sherene; Kakkos, Stavros; Zhang, Qianzi; Lawrence, Peter ...; Woo, Karen; Chung, Jayer; visa färre...

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