Infective Etiology Affects Outcomes of Late Open Conversion After Failed Endovascular Aneurysm Repair

医学 外科 动脉瘤 腔内修复术 围手术期 病因学 腹主动脉瘤 败血症 感染性休克 心肌梗塞 内科学
作者
Danilo Menna,Laura Capoccia,Pasqualino Sirignano,Danilo Menna,Massimo Rossi,Francesco Speziale
出处
期刊:Journal of Endovascular Therapy [SAGE Publishing]
卷期号:22 (1): 110-115 被引量:18
标识
DOI:10.1177/1526602814562777
摘要

To retrospectively review all patients undergoing late open conversion (LOC) after endovascular aneurysm repair (EVAR) in order to identify any clinical or technical predictors of poor outcome.Twenty-six consecutive patients (24 men; mean age 74.7 ± 8.3 years) underwent LOC between June 2006 and April 2013 at our institution. The mean interval from index EVAR to LOC was 40.4 ± 29.2 months (range 5-93 months). The indication for LOC was endoleak in 14 (54%) patients and infection in 12 (46%): 2 (8%) patients with endoleak had a ruptured aneurysm and 6 (23%) patients with infection had a recurrent secondary aortoesophageal fistula (sAEF).In all 12 cases of infection and in 12 of 14 endoleaks, the entire endograft was explanted. A rifampin-soaked Dacron silver graft was implanted in all patients with infection. Patients with any infection and with recurrent AEF required more blood units than patients with endoleak (6.40 vs. 1.86, p = 0.045; 6.76 vs. 1.86, p = 0.0036, respectively). Compared with endoleak, the duration of conversions in the setting of infection (274 vs. 316 minutes, p = 0.42) and recurrent sAEF (274 vs. 396 minutes, p = 0.021) was longer. All patients with recurrent sAEF died at a mean 3.0 ± 2.5 days after LOC from proximal anastomosis disruption and hemorrhagic shock (n = 2), myocardial infarction (n = 2), acute stroke (n = 1), or persistent sepsis (n = 1). Perioperative mortality was significantly higher in patients with endograft infection (6/12, p = 0.002) and in cases of supraceliac cross-clamping (4/6, p = 0.003). The association of infection with supraceliac cross-clamping was a strong predictor for perioperative mortality (p < 0.001).In our experience, endograft infection led to greater perioperative mortality after LOC. Recurrent aortoenteric fistula in association with supraceliac cross-clamping is a strong predictor of poor outcome. Patients surviving the perioperative period may have good chances of long-term survival.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Lucas应助qi0625采纳,获得10
刚刚
顾矜应助以筱采纳,获得10
1秒前
景清完成签到,获得积分10
1秒前
细心香烟完成签到 ,获得积分10
1秒前
hu完成签到 ,获得积分10
1秒前
HQ完成签到,获得积分10
1秒前
2秒前
水清木华完成签到,获得积分10
2秒前
3秒前
miao完成签到,获得积分20
3秒前
xyp_zjut应助学术乞丐采纳,获得10
3秒前
Lucas应助凉白开采纳,获得10
3秒前
体贴凌柏发布了新的文献求助10
4秒前
4秒前
4秒前
鹿子完成签到 ,获得积分10
4秒前
秋枫忆完成签到,获得积分10
6秒前
宋立发布了新的文献求助10
6秒前
孤独的AD钙完成签到,获得积分10
6秒前
7秒前
fang应助miao采纳,获得10
8秒前
星辰与月完成签到,获得积分10
8秒前
Pt-SACs发布了新的文献求助10
8秒前
安静无招完成签到 ,获得积分10
12秒前
lqphysics完成签到,获得积分10
13秒前
Jerry完成签到 ,获得积分10
13秒前
枕星发布了新的文献求助10
13秒前
全职法师刘海柱完成签到,获得积分10
15秒前
Umar完成签到,获得积分10
15秒前
accepted完成签到,获得积分10
16秒前
17秒前
Pt-SACs完成签到,获得积分10
18秒前
wgglegg完成签到 ,获得积分10
18秒前
饱满跳跳糖完成签到,获得积分10
18秒前
zhaoxiaonuan完成签到,获得积分10
18秒前
19秒前
赘婿应助2023204306324采纳,获得10
19秒前
英勇笑萍完成签到,获得积分10
20秒前
yar完成签到 ,获得积分10
21秒前
22秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038368
求助须知:如何正确求助?哪些是违规求助? 3576068
关于积分的说明 11374313
捐赠科研通 3305780
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029