Aortic Paraprosthetic-colonic Fistulae: A Review of the Literature

León, Luis R.; Mills, Joseph L.; Psalms, Shemuel B.; Kasher, John A.; Kim, J.; Ihnat, Daniel M.

doi:10.1016/j.ejvs.2007.07.003

Cited by 21 publications

(17 citation statements)

References 60 publications

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“…Graft infection after EVAR or OSR may present in isolation or in association with a fistula to a neighboring viscus, most commonly the duodenum. 434,435 Primary aortic graft infection usually presents late, on the average three years after implantation and on occasion much later. 432 Femoral extension of the abdominal grafts increases the incidence of graft infection from 1% to nearly 3%, as determined by an 18-year review of 664 patients treated by OSR.…”

Section: Late Outcomes After Open Surgery and Evarmentioning

confidence: 99%

“…434,437 Although the duodenum is most frequently affected, all viscera, including small and large bowel, have been implicated. 435,437 A common presentation is upper gastrointestinal (UGI) bleeding. 448 Herald bleeds may ultimately progress to an exsanguinating hemorrhage, if the source of the bleeding is not identified and treated promptly.…”

Section: Late Outcomes After Open Surgery and Evarmentioning

confidence: 99%

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The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Chaikof

Brewster

Dalman

et al. 2009

Journal of Vascular Surgery

636

520

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DEFINITION OF THE PROBLEM Purpose of these guidelinesThe Clinical Practice Council of the Society for Vascular Surgery charged a writing committee with the task of updating practice guidelines, initally published in 2003, for surgeons and physicians who are involved in the preoperative, operative, and postoperative care of patients with abdominal aortic aneurysms (AAA). 1 This document provides recommendations for evaluating the patient, including risk of aneurysm rupture and associated medical co-morbidities, guidelines for selecting surgical or endovascular intervention, intraoperative strategies, perioperative care, long-term follow-up, and treatment of late complications.Decision making related to the care of patients with AAA is complex. Aneurysms present with varying risks of rupture and patient specific factors influence anticipated life expectancy, operative risk, and the need to intervene. Careful attention to the choice of operative strategy, as influenced by anatomic features of the AAA, along with optimal treatment of medical co-morbidities is critical to achieving excellent outcomes. Moreover, appropriate postoperative patient surveillance and timely intervention in the case of a late complication is necessary to minimize subsequent aneurysm-related death or morbidity. All of these clinical decisions are determined in an environment where cost-effectiveness will ultimately dictate the ability to provide optimal care to the largest possible segment of the population. Currently available clinical data sets have been reviewed in formulating these recommendations. However, an important goal of this document is to clearly identify those areas where further clinical research is necessary. Methodology and evidenceA comprehensive review of the available clinical evidence in the literature was conducted in order to generate a concise set of recommendations. The strength of any given recommendation and the quality of evidence was scored based on the GRADE system (Table I). 2 When the benefits of an intervention outweighed its risks, or, alternatively, risks outweighed benefits, a strong recommendation was noted. However, if benefits and risks were less certain, either because of low quality evidence or because high quality evidence suggests benefits and risks are closely balanced, a weak recommendation was recorded. The quality of evidence that formed the basis of these recommendations was scored as high, moderate, or low. Not all randomized controlled trials are alike and limitations may compromise the quality of their evidence. In addition, if there is a large magnitude of effect, the quality of evidence derived from observational studies may be high. Thus, quality of evidence was scored as high when additional research is considered very unlikely to change confidence in the estimate of effect; moderate when further research is likely to have an important impact in the estimate of effect; or low when further research is very likely to change the estimate of the effect.

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Section: Late Outcomes After Open Surgery and Evarmentioning

confidence: 99%

Section: Late Outcomes After Open Surgery and Evarmentioning

confidence: 99%

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Chaikof

Brewster

Dalman

et al. 2009

Journal of Vascular Surgery

636

520

View full text Add to dashboard Cite

show abstract

“…Los más habituales entre estos últimos son los síntomas depresivos y ansiosos, siendo mucho más raros los psicóticos y maniformes 3 . Está muy bien establecido que el uso de psicofármacos es muy importante de cara a maximizar la adherencia en pacientes con hepatitis C crónica que desarrollan síndromes psicopatológicos durante los meses de tratamiento [4][5][6][7] . Sin embargo, hay pocos estudios sobre la evolución de estos trastornos mentales y algunos autores señalan que una parte de ellos podría persistir a lo largo del tiempo, manteniéndose la necesidad de tratamiento psiquiátrico continuado 6,8,9 .…”

Section: Sr Directorunclassified

“…Por otro lado, no hemos encontrado datos en la bibliografía sobre incidencia de consumo a largo plazo de psicofármacos en estos pacientes, especialmente de benzodiacepinas que tienen problemas de manejo a medio y largo plazo. Este punto es especialmente relevante, dado que un porcentaje muy importante de pacientes con hepatitis C tiene antecedentes de abuso de drogas [2][3][4] .…”

Section: Sr Directorunclassified

“…Las fístulas aorto-entéricas (FAE) representan una entidad infrecuente como etiología de sangrado digestivo, asocián-dose a una elevada mortalidad si existe demora en su diagnóstico y por tanto en su tratamiento [1][2][3][4][5] . Dichas fístulas surgen de una comunicación directa entre la aorta y el tracto gastrointestinal, bien de forma primaria en pacientes con aneurismas ateroscleróticos de aorta abdominal o de forma secundaria en pacientes con prótesis de aorta abdominal insertadas previamente 1 .…”

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