دورية أكاديمية
Staging the neoaortoiliac system: feasibility and short-term outcomes.
| العنوان: | Staging the neoaortoiliac system: feasibility and short-term outcomes. |
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| المؤلفون: | Ali AT; Division of Vascular Surgery, The University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. aali@uams.edu, McLeod N, Kalapatapu VR, Moursi MM, Eidt JF |
| المصدر: | Journal of vascular surgery [J Vasc Surg] 2008 Nov; Vol. 48 (5), pp. 1125-30; discussion 1130-1. Date of Electronic Publication: 2008 Sep 19. |
| نوع المنشور: | Comparative Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2008-> : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby, [c1984- |
| مواضيع طبية MeSH: | Vascular Surgical Procedures*/adverse effects , Vascular Surgical Procedures*/mortality, Aorta/*surgery , Blood Vessel Prosthesis/*adverse effects , Blood Vessel Prosthesis Implantation/*adverse effects , Femoral Vein/*transplantation , Popliteal Vein/*transplantation , Prosthesis-Related Infections/*surgery, Aged ; Aorta/microbiology ; Blood Vessel Prosthesis Implantation/instrumentation ; Device Removal ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/microbiology ; Prosthesis-Related Infections/mortality ; Registries ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Vascular Patency |
| مستخلص: | Background: The neoaortoiliac system (NAIS) has gained popularity as a durable procedure for treating aortic graft infections. However, one of the disadvantages has been a long operation that can take up to 10 hours. The goal of this study was to assess the feasibility of staging the NAIS procedure with deep vein harvest a day before the aortofemoral bypass and evaluate if staging had any effect on graft patency or morbidity and mortality, or both. Methods: We reviewed data for all the NAIS procedures performed for aortic graft infections at a tertiary care university hospital. The femoral popliteal veins of patients undergoing the staged NAIS were harvested a day in advance and left in situ. The next day patients underwent the prosthetic graft excision with reconstruction using the femoral popliteal veins. Patients with aortic occlusion on presentation were not candidates for vein harvest in advance and underwent a unilateral bypass with a subsequent femorofemoral bypass as a second stage. Results: In the last 8 years, 26 patients (17 men, 9 women; mean age, 62.6 +/- 8.3 years) underwent the NAIS procedure for aortic graft infections. Mean follow-up was 15.7 months. Primary assisted graft patency was 100%. There were 11 patients in the staged group and 10 patients in the nonstaged group. All the staged patients underwent vein mobilization a day before excision of aortic prosthesis. Despite undergoing a separate procedure for vein harvesting at a different time, there was no difference in total operative time (12.0 +/- 1.8 vs 11.9 +/- 2.2 hours), operative blood loss (2.6 +/- 1.2 vs 3.4 +/- 2.4 L), and requirements for transfusion for blood products (6.7 +/- 3.7 vs 6.0 +/- 5.4 U) or crystalloid (11.3 +/- 3.1 vs 10.9 +/- 2.4 L) between the staged group and nonstaged groups. One amputation occurred in each group. The perioperative mortality was 18% for the staged group and 20% for nonstaged group. The 12-month survival was 72% for staged and 70% for nonstaged NAIS. No graft-related complications were observed from the preoperative vein harvest. Conclusion: The NAIS can be staged without compromising the efficacy of the procedure as evident by excellent long-term patency and control of the infection. By reducing the duration of the primary procedure, staging may be beneficial to both the patient and the surgeon. |
| تواريخ الأحداث: | Date Created: 20080923 Date Completed: 20081113 Latest Revision: 20121003 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jvs.2008.06.067 |
| PMID: | 18804940 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-6809 |
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| DOI: | 10.1016/j.jvs.2008.06.067 |