Improved results with conventional management of infrarenal aortic infection

R. A. Yeager, Jr Taylor L.M., Gregory (Greg) Moneta, James Edwards, A. D. Nicoloff, Donald McConnell, J. M. Porter, R. J. Stoney

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Purpose: Interest in alternative methods, such as autogenous vein grafts and aortic allografts, for the management of infrarenal aortic infection (IRAI) has been stimulated by the historically disappointing results with conventional surgical management. Recently, there have been dramatic improvements in the results of axillofemoral bypass grafting (AXFB) followed by excision of the IRAI that have gene relatively unrecognized. The purpose of this report is the presentation of modern-day results in the treatment of IRAI with conventional surgical methods. Methods: From January 1, 1983, through June 30, 1998, patients with IRAI underwent treatment with AXFB and complete excision of the IRAI. The patients were followed for survival, limb salvage, and AXFB graft patency. The results were tabulated with life-table methods. Results: During the 15-year study period, 60 patients (51 men, nine women; mean age, 68 years) underwent treatment for IRAI (50 graft infections, including 16 graft-enteric fistulae, and 10 primary aortic infections). The mean follow-up period was 41 months. The perioperative mortality rate was 13% (12% for graft infection, and 20% for primary infection). The overall 2-year and 5-year survival rates were 67% and 47%, respectively. The limb salvage rates at 2 and 5 years were 93% and 82%, respectively. The 5-year primary AXFB graft patency rate was 73%. Conclusion: These results show an improvement with the conventional management of IRAI equal or superior to those results reported with alternative methods, including femoral vein grafts or aortic allografts. These results should be regarded as the modern standard with which alternative therapies can be compared.

Original languageEnglish (US)
Pages (from-to)76-83
Number of pages8
JournalJournal of Vascular Surgery
Volume30
Issue number1
DOIs
StatePublished - 1999
Externally publishedYes

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Infection
Transplants
Limb Salvage
Allografts
Life Tables
Femoral Vein
Complementary Therapies
Fistula
Veins
Therapeutics
Survival Rate
Survival
Mortality
Axillofemoral Bypass Grafting
Genes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Improved results with conventional management of infrarenal aortic infection. / Yeager, R. A.; Taylor L.M., Jr; Moneta, Gregory (Greg); Edwards, James; Nicoloff, A. D.; McConnell, Donald; Porter, J. M.; Stoney, R. J.

In: Journal of Vascular Surgery, Vol. 30, No. 1, 1999, p. 76-83.

Research output: Contribution to journalArticle

Yeager, RA, Taylor L.M., J, Moneta, GG, Edwards, J, Nicoloff, AD, McConnell, D, Porter, JM & Stoney, RJ 1999, 'Improved results with conventional management of infrarenal aortic infection', Journal of Vascular Surgery, vol. 30, no. 1, pp. 76-83. https://doi.org/10.1016/S0741-5214(99)70178-3
Yeager, R. A. ; Taylor L.M., Jr ; Moneta, Gregory (Greg) ; Edwards, James ; Nicoloff, A. D. ; McConnell, Donald ; Porter, J. M. ; Stoney, R. J. / Improved results with conventional management of infrarenal aortic infection. In: Journal of Vascular Surgery. 1999 ; Vol. 30, No. 1. pp. 76-83.
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AU - McConnell, Donald

AU - Porter, J. M.

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N2 - Purpose: Interest in alternative methods, such as autogenous vein grafts and aortic allografts, for the management of infrarenal aortic infection (IRAI) has been stimulated by the historically disappointing results with conventional surgical management. Recently, there have been dramatic improvements in the results of axillofemoral bypass grafting (AXFB) followed by excision of the IRAI that have gene relatively unrecognized. The purpose of this report is the presentation of modern-day results in the treatment of IRAI with conventional surgical methods. Methods: From January 1, 1983, through June 30, 1998, patients with IRAI underwent treatment with AXFB and complete excision of the IRAI. The patients were followed for survival, limb salvage, and AXFB graft patency. The results were tabulated with life-table methods. Results: During the 15-year study period, 60 patients (51 men, nine women; mean age, 68 years) underwent treatment for IRAI (50 graft infections, including 16 graft-enteric fistulae, and 10 primary aortic infections). The mean follow-up period was 41 months. The perioperative mortality rate was 13% (12% for graft infection, and 20% for primary infection). The overall 2-year and 5-year survival rates were 67% and 47%, respectively. The limb salvage rates at 2 and 5 years were 93% and 82%, respectively. The 5-year primary AXFB graft patency rate was 73%. Conclusion: These results show an improvement with the conventional management of IRAI equal or superior to those results reported with alternative methods, including femoral vein grafts or aortic allografts. These results should be regarded as the modern standard with which alternative therapies can be compared.

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