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Improved results with conventional management of infrarenal aortic infection
- Source :
- Journal of Vascular Surgery. 30(1):76-83
- Publication Year :
- 1999
- Publisher :
- Elsevier BV, 1999.
-
Abstract
- Purpose: Interest in alternative methods, such as autogenous vein grafts and aortic allografts, for the management of infrarenal aortic infection (IRAI) has been stimulated by the historically disappointing results with conventional surgical management. Recently, there have been dramatic improvements in the results of axillofemoral bypass grafting (AXFB) followed by excision of the IRAI that have gone relatively unrecognized. The purpose of this report is the presentation of modern-day results in the treatment of IRAI with conventional surgical methods. Methods: From January 1, 1983, through June 30, 1998, patients with IRAI underwent treatment with AXFB and complete excision of the IRAI. The patients were followed for survival, limb salvage, and AXFB graft patency. The results were tabulated with life-table methods. Results: During the 15-year study period, 60 patients (51 men, nine women; mean age, 68 years) underwent treatment for IRAI (50 graft infections, including 16 graft-enteric fistulae, and 10 primary aortic infections). The mean follow-up period was 41 months. The perioperative mortality rate was 13% (12% for graft infection, and 20% for primary infection). The overall 2-year and 5-year survival rates were 67% and 47%, respectively. The limb salvage rates at 2 and 5 years were 93% and 82%, respectively. The 5-year primary AXFB graft patency rate was 73%. Conclusion: These results show an improvement with the conventional management of IRAI equal or superior to those results reported with alternative methods, including femoral vein grafts or aortic allografts. These results should be regarded as the modern standard with which alternative therapies can be compared. (J Vasc Surg 1999;30:76-83.)
- Subjects :
- Male
medicine.medical_specialty
Prosthesis-Related Infections
Axillofemoral Bypass Grafting
Femoral vein
Aortic Diseases
medicine
Vascular Patency
Humans
Surgical Wound Infection
Aorta, Abdominal
Vein
Survival rate
Aged
Vascular disease
business.industry
Mortality rate
Perioperative
medicine.disease
Surgery
Blood Vessel Prosthesis
Femoral Artery
Survival Rate
medicine.anatomical_structure
Axillary Artery
Female
Radiology
business
Cardiology and Cardiovascular Medicine
Subjects
Details
- ISSN :
- 07415214
- Volume :
- 30
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of Vascular Surgery
- Accession number :
- edsair.doi.dedup.....9b59fff5e6f87cb2392aec001af197de
- Full Text :
- https://doi.org/10.1016/s0741-5214(99)70178-3