Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

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

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Re: "Preservation of the Great Saphenous Vein and the 2022 European Society for Vascular Surgery Guidelines"

    Research output: Contribution to journalLetterResearchpeer-review

  2. Endovascular Repair for Juxtarenal Aortic Aneurysm - Network Meta-Analysis Support ESVS AAA guidelines!

    Research output: Contribution to journalComment/debateResearchpeer-review

  3. Intravascular Ultrasound as a Valuable Tool in Iliac Endofibrosis Diagnostics

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Revascularisation for Symptomatic Peripheral Artery Disease: External Applicability of the VOYAGER PAD Trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Features of infective native aortic aneurysms on computed tomography

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Comment on: Nationwide study of surgery for primary infected abdominal aortic and common iliac artery aneurysms

    Research output: Contribution to journalComment/debateResearchpeer-review

  3. Systematic review of endovascular versus open repair of infected abdominal aortic aneurysm-bias in, bias out

    Research output: Contribution to journalReviewResearchpeer-review

  4. The Microbiology of Infective Native Aortic Aneurysms in a Population-Based Setting

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Hamid Gavali
  • Kevin Mani
  • Mia Furebring
  • Karl W Olsson
  • David Lindström
  • Karl Sörelius
  • Birgitta Sigvant
  • Khatereh D Gidlund
  • Gustav Torstensson
  • Manne Andersson
  • Claes Forssell
  • Håkan Åstrand
  • Tobias Lundström
  • Shahzad Khan
  • Björn Sonesson
  • Otto Stackelberg
  • Peter Gillgren
  • Jon Isaksson
  • Björn Kragsterman
  • Tal Horer
  • Mitra Sadeghi
  • Anders Wanhainen
View graph of relations

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.

Original languageEnglish
JournalEuropean journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
Volume62
Issue number6
Pages (from-to)918-926
Number of pages9
ISSN1078-5884
DOIs
Publication statusPublished - Dec 2021

Bibliographical note

Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

    Research areas

  • Aged, Aorta, Abdominal/diagnostic imaging, Blood Vessel Prosthesis Implantation/adverse effects, Blood Vessel Prosthesis/adverse effects, Endovascular Procedures/adverse effects, Female, Humans, Male, Middle Aged, Prosthesis-Related Infections/diagnostic imaging, Registries, Reoperation, Retrospective Studies, Risk Assessment, Risk Factors, Sweden, Time Factors, Treatment Outcome

ID: 74849571