Titre :

In-situ Bypass and Extra-anatomic Bypass Procedures Result in Similar Survival in Patients with Secondary Aorto-Enteric Fistulae.

Auteur(s) :

Janko, Matthew R. [Auteur]
Case Western Reserve University [Cleveland]
Woo, Karen [Auteur]
University of California [Los Angeles] [UCLA]
Hacker, Robert I. [Auteur]
Baril, Donald [Auteur]
University of California [Los Angeles] [UCLA]
Bath, Jonathan [Auteur]
University of Missouri [Columbia] [Mizzou]
Smeds, Matthew R. [Auteur]
Kashyap, Vikram S. [Auteur]
Case Western Reserve University [Cleveland]
Szeberin, Zoltan [Auteur]
Semmelweis University of Medicine [Budapest]
Magee, Gregory [Auteur]
University of Southern California [USC]
Elsayed, Ramsey [Auteur]
University of Southern California [USC]
Wishy, Andrew [Auteur]
University of California [Davis] [UC Davis]
St John, Rebecca [Auteur]
University of Alabama at Birmingham [ Birmingham] [UAB]
Beck, Adam [Auteur]
University of Alabama at Birmingham [ Birmingham] [UAB]
Farber, Mark [Auteur]
University of North Carolina [Chapel Hill] [UNC]
Motta, Fernando [Auteur]
University of North Carolina [Chapel Hill] [UNC]
Zhou, Wei [Auteur]
University of Arizona
Lemmon, Gary [Auteur]
Coleman, Dawn [Auteur]
University of Michigan [Ann Arbor]
Behrendt, Christian-Alexander [Auteur]
Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] [UKE]
Aziz, Faisal [Auteur]
Medical University of Graz = Medizinische Universität Graz
Black, James [Auteur]
Johns Hopkins University School of Medicine [Baltimore]
Shutze, William [Auteur]
Garrett, H. Edward [Auteur]
De Caridi, Giovanni [Auteur]
Università degli Studi di Messina = University of Messina [UniMe]
Liapis, Christos [Auteur]
University of Athens Medical School [Athens]
Geroulakos, George [Auteur]
“Attikon” University Hospital
Kakisis, John [Auteur]
University of Athens Medical School [Athens]
Moulakakis, Konstantinos [Auteur]
University of Athens Medical School [Athens]
Kakkos, Stavros [Auteur]
University of Patras
Obara, Hideaki [Auteur]
Keio University [Tokyo]
Wang, Grace [Auteur]
National Cheng Kung University [NCKU]
Rhéaume, Pascal [Auteur]

Davila, Victor [Auteur]
Mayo Clinic
Ravin, Reid [Auteur]
Demartino, Randall [Auteur]
Mayo Clinic [Rochester]
Milner, Ross [Auteur]
University of Chicago
Shalhub, Sherene [Auteur]
University of Washington [Seattle]
Jim, Jeffrey [Auteur]
Washington University School of Medicine [Saint Louis, MO]
Lee, Jason [Auteur]
Dubuis, Celine [Auteur]
Coselli, Joseph [Auteur]
Lemaire, Scott [Auteur]
Fatima, Javairiah [Auteur]
Sanford, Jennifer [Auteur]
Yoshida, Winston [Auteur]
Schermerhorn, Marc [Auteur]
Menard, Matthew [Auteur]
Brigham and Women's Hospital [Boston]
Belkin, Michael [Auteur]
Brigham and Women's Hospital [Boston]
Blackwood, Stuart [Auteur]
Brigham and Women's Hospital [Boston]
Conrad, Mark [Auteur]
Massachusetts General Hospital [Boston]
Wang, Linda [Auteur]
Massachusetts General Hospital [Boston]
Crofts, Sara [Auteur]
Massachusetts General Hospital [Boston]
Nixon, Thomas [Auteur]
Massachusetts General Hospital [Boston]
Wu, Timothy [Auteur]
Robert Wood Johnson Medical School [Piscataway, NJ] [RWJMS]
Chiesa, Roberto [Auteur]
Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie] [UniSR]
Bose, Saideep [Auteur]
Case Western Reserve University [Cleveland]
Turner, Jason [Auteur]
Case Western Reserve University [Cleveland]
Moore, Ryan [Auteur]
University of Delaware [Newark]
Smith, Justin [Auteur]
Public Health England [London]
Ciocca, Rocco [Auteur]
Case Western Reserve University [Cleveland]
Hsu, Jeffrey [Auteur]
Kaiser Permanente
Czerny, Martin [Auteur]

Cullen, Jonathan [Auteur]
Kahlberg, Andrea [Auteur]
San Raffaele Scientific Institute
Setacci, Carlo [Auteur]
Università degli Studi di Siena = University of Siena [UNISI]
Joh, Jin Hyun [Auteur]
Kyung Hee University [KHU]
Senneville, Eric [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Garrido, Pedro [Auteur]
Universidad de Granada = University of Granada [UGR]
Sarac, Timur [Auteur]
The Ohio State University [Columbus] [OSU]
Rizzo, Anthony [Auteur]
The Ohio State University [Columbus] [OSU]
Go, Michael [Auteur]
The Ohio State University [Columbus] [OSU]
Bjorck, Martin [Auteur]
Uppsala Universitet [Uppsala]
Gavali, Hamid [Auteur]
Uppsala Universitet [Uppsala]
Wanhainen, Anders [Auteur]
Uppsala Universitet [Uppsala]
Lawrence, Peter F. [Auteur]
University of California [Los Angeles] [UCLA]
Chung, Jayer [Auteur]

Titre de la revue :

Journal of Vascular Surgery

Nom court de la revue :

J. Vasc. Surg.

Numéro :

73

Pagination :

210-221

Date de publication :

2020-06-06

ISSN :

1097-6809

Mot(s)-clé(s) en anglais :

Aortoenteric fistula
Aorta

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Objective The optimal revascularization modality in secondary aortoenteric fistula (SAEF) remains unclear in the literature. The purpose of this investigation was to determine the revascularization approach associated ...
Lire la suite >Objective The optimal revascularization modality in secondary aortoenteric fistula (SAEF) remains unclear in the literature. The purpose of this investigation was to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients with SAEF. Methods A retrospective, multi-institutional study of SAEF from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and operative and postoperative variables were recorded. The primary outcome was long-term mortality. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariate analyses were performed. Results During the study period, 182 patients at 34 institutions from 11 countries presented with SAEF (median age, 72 years; 79% male). The initial aortic procedures that resulted in SAEF were 138 surgical grafts (76%) and 42 endografts (23%), with 2 unknown; 102 of the SAEFs (56%) underwent complete excision of infected aortic graft material, followed by in situ (in-line) bypass (ISB), including antibiotic-soaked prosthetic graft (53), autogenous femoral vein (neoaortoiliac surgery; 17), cryopreserved allograft (28), and untreated prosthetic grafts (4). There were 80 patients (44%) who underwent extra-anatomic bypass (EAB) with infected graft excision. Overall median Kaplan-Meier estimated survival was 319 days (interquartile range, 20-2410 days). Stratified by EAB vs ISB, there was no significant difference in Kaplan-Meier estimated survival (P = .82). In comparing EAB vs ISB, EAB patients were older (74 vs 70 years; P = .01), had less operative hemorrhage (1200 mL vs 2000 mL; P = .04), were more likely to initiate dialysis within 30 days postoperatively (15% vs 5%; P = .02), and were less likely to experience aorta-related hemorrhage within 30 days postoperatively (3% aortic stump dehiscence vs 11% anastomotic rupture; P = .03). There were otherwise no significant differences in presentation, comorbidities, and intraoperative or postoperative variables. Multivariable Cox regression showed that the duration of antibiotic use (hazard ratio, 0.92; 95% confidence interval, 0.86-0.98; P = .01) and rifampin use at time of discharge (hazard ratio, 0.20; 95% confidence interval, 0.05-0.86; P = .03) independently decreased mortality. Conclusions These data suggest that ISB does not offer a survival advantage compared with EAB and does not decrease the risk of postoperative aorta-related hemorrhage. After repair, <50% of SAEF patients survive 10 months. Each week of antibiotic use decreases mortality by 8%. Further study with risk modeling is imperative for this population.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2023-11-15T08:48:46Z
2024-01-11T12:45:57Z