Mid-Term Outcome of Infected Abdominal Aortic Stent Graft Dismantlement with Reconstruction of Bilateral Axillofemoral Bypass

Ching Li Chen, Tzu Ting Kuo, I. Ming Chen, Tai Wei Chen, Po Lin Chen, Chun Yang Huang, Chun Che Shih

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Abdominal aortic stent graft infection (AAGI) is a severe complication. The optimal management of AAGI remains unclear. This study provides updated results of bilateral axillofemoral bypasses (AFBs) for patients with AAGI. Patients and Methods: In total, 31 patients (25 men; mean age, 67.1 years) with AAGI treated using AFB between January 2006 and April 2020 were included. Overall, the mean follow-up duration was 24 months (range, 1-72). In the 23 patients who survived the post-operative period, the mean follow-up duration was 32 months (range, 12-72). Results: Thirty-day and in-hospital mortality rates was 16% and 26%, respectively. The 12-month primary and secondary patency rates for the AFB graft were both 91%. In total, seven (30%) patients received re-interventions such as thrombectomy and balloon angioplasty. No amputation was required during follow-up. Culture results were positive in 87% of pre-operative cultures and 84% of intra-operative cultures. Staphylococcus aureus was the most prevalent pathogen, with four cases of methicillin-resistant Staphylococcus aureus and one each of vancomycin-resistant enterococci, carbapenem-resistant Klebsiella pneumoniae, and carbapenem-resistant Enterobacteriaceae. In-hospital mortality rate was 57% in patients with drug-resistant pathogens. Conclusions: Reconstruction with bilateral AFB and stent graft removal in patients with AAGI is a feasible treatment modality and provided an acceptable patency rate and low amputation rate. Additional studies investigating long-term results and the optimal treatment of AAGI are required.

Original languageEnglish
Pages (from-to)680-683
Number of pages4
JournalSurgical Infections
Volume22
Issue number7
DOIs
Publication statusPublished - Sep 1 2021

Keywords

  • abdominal aortic aneurysm
  • axillofemoral bypass
  • infected stent
  • stent graft

ASJC Scopus subject areas

  • Surgery
  • Microbiology (medical)
  • Infectious Diseases

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