Management and Outcome of Prosthetic Vascular Graft Infections: A Single Center Experience

Elens, Maxime; Dusoruth, Muzhakkir; Astarci, Parla; Mastrobuoni, Stefano; Bosiers, Michel; Nardella, Jane; Lacroix, Valérie; Possoz, Julien; Verhelst, Robert

doi:10.1177/1538574418754453

Cited by 25 publications

(20 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The management of infected aneurysms remains a challenge in current practice, with reported hospital mortality rates ranging from 16 to 44%. [13] Almost all untreated aneurysm eventually leads to rupture. No randomized controlled trials exist to guide the treatment of infected aneurysms, with management strategies primarily based upon clinical experience and available case series.…”

Section: Discussionmentioning

confidence: 99%

“…A significant concern with in-situ reconstruction with prosthetic graft material is the development of prosthetic graft infection. Prosthetic graft infections occur in 1%–6% of cases after vascular graft implantation procedures [13]. Intraoperative bacterial contamination is cited as the most common cause, with other causes including bacterial colonization of the thrombus or direct inoculation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A rare case of Listeria monocytogenes causing mycotic aneurysm of the common femoral artery: A case report

Pathmarajah

Chu

Sieunarine

2019

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

Highlights Immunosuppressed patients may not display typical clinical or biochemical features associated with mycotic aneurysms. Clinicians should have a high index of suspicion for infective aetiology when treating aneurysmal disease in immunocompromised patients. It is important to obtain intraoperative tissue samples for histopathology and microbiological assessment in immunocompromised patients for detection of rare pathogens. Autogenous vein should be used in infected surgical fields to avoid the risk of prosthetic graft infection.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A rare case of Listeria monocytogenes causing mycotic aneurysm of the common femoral artery: A case report

Pathmarajah

Chu

Sieunarine

2019

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…Eleven studies reported on venous substitutes with an average score of 10.6. 9,18,21,22,25,26,29,32,33,35,36 Regarding the studies on arterial and prosthetic reconstructions, the average MI-NORS scores were 13.3 13,17,19,26e29,32,34,35 and 13.1. 5e 12,14e16,20,23,24,27e32 None of the studies met the criteria for good quality.…”

Section: Recurrence Of Infectionmentioning

confidence: 99%

“…23,32 Interestingly, these studies had the highest pooled recurrence rate of 39.3% (95% CI 13.2e 65.4), 23,32 while the average recurrence rate in 14 studies performing complete graft removal was 5.4% (95% CI 3.2e 7.5). 5,8,9,11,13,14,16,23,25,26,28,33,35,36 Analysis of the studies performing ISR demonstrated a pooled recurrent infection rate of 5.7% (95% CI 3.5e 8.0) 11,13,14,17,18,24e26,28,33,35 vs. a 4.1% (95% CI 3.3e12.8) recurrence rate for studies performing EAR. 16,23 Further analysis of the graft material used in those studies performing ISR demonstrated a pooled infection recurrence rate of 4.8% (95% CI 2.3e7.4; four studies) when autologous veins were used.…”

Section: Recurrence Of Infectionmentioning

confidence: 99%

Systematic Review and Meta-Analysis on the Management of Open Abdominal Aortic Graft Infections

Post

Vos

2019

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

WHAT THIS PAPER ADDS A systematic review of the literature was performed adhering to the PRISMA guidelines with strict selection criteria for study design, patient inclusion and exclusion criteria, and outcome reporting. This contributed to comparability of the individual study data. Since 2006 many new studies have been performed and these are included in the systematic review. Strict definitions and outcome criteria were used to improve comparability between the outcome data of the included studies. Objective: Aortic graft infection (AGI) is a disastrous complication with an incidence of 0.2e6% in operated patients. With little or no high quality evidence, the best treatment option remains unclear. Therefore, the literature on the management of open abdominal AGI was systematically reviewed to determine optimal treatment. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review and meta-analysis was conducted for AGI. MEDLINE, Embase, and the Cochrane Database of Systematic Reviews were searched. Methodological quality was assessed using the Methodological Index for Non-randomised Studies (MINORS) score. Primary outcomes were 30 day mortality and one year survival. Secondary outcomes were survival, infection recurrence, limb salvage, and graft patency. Results: Of 1574 studies identified, 32 papers were included in the study. The overall quality of the studies was moderate, with an average MINORS score of 11.9. Pooled overall 30 day mortality and one year survival were 13.5% (95% CI 10.5e16.4) and 73.6% (95% CI 68.8e78.4), respectively. The lowest 30 day mortality and highest one year survival were found for in situ repair compared with extra-anatomic repair and for prosthetic grafts compared with venous grafts or arterial allografts. The infection recurrence rate was highest for prosthetic grafts. Conclusions: There is a lack of well designed, qualitative comparative studies making conclusive recommendations impossible. The current best available data suggests that partial graft removal should be avoided and the lowest 30 day mortality and best one year survival are achieved with in situ repair using prosthetic grafts. Initiatives such as the MAGIC database to collaboratively collect prospective data are an important step forward in obtaining more solid answers on this topic.

show abstract

“…Methicillin-resistant Staphylococcus epidermidis (MRSE) is the common cause of these infections, [9,10] which usually does not respond to antibiotherapy, requiring graft excision. [11] Mesenchymal stem cells (MSCs) have immunomodulatory and anti-inflammatory effect achieved by change in T helper subtypes, regulation of the activity of macrophages and changing proliferation, differentiation and immunsecretion characteristics of B cells. [12,13] They also show direct antibacterial effect achieved by secretion of antibacterial peptides and augmentation of phagocytosis.…”

mentioning

confidence: 99%

Mesenchymal stem cells have significant anti-infective effect on methicillin-resistant Staphylococcus epidermidis vascular graft infections

Canbeyli

Kabalcı

Çirpar

et al. 2019

Eklem Hastalik Cerrahisi

View full text Add to dashboard Cite

ÖZ Amaç: Bu çalışmada, mezenkimal kök hücre (MKH) implantasyonunun metisiline dirençli Stafilokokus epidermidis (MDSE)'in neden olduğu vasküler greft enfeksiyonları üzerindeki etkileri değerlendirildi ve antibiyotik tedavisi ile karşılaştırıldı. Gereç ve yöntemler: Sağlıklı erişkin 56 Wistar sıçanı (yaş, 5 ay üzeri; ağırlık, 300-350 g) sekiz gruba ayrıldı. Grup 1 kontrol grubu, grup 2 enfekte kontrol grubu olarak tanımlandı. Grup 3 ve 4 Dakron grefti uygulanan, MDSE ile enfekte olan, sırasıyla tigesiklin ve MKH tedavisi uygulanan gruplar olarak tanımlandı. Grup 5 ve 6 politetrafloroetilen (PTFE) greft uygulanarak MDSE ile enfekte edildi. Bu gruplara da sırasıyla tigesiklin ve MKH tedavisi uygulandı. Grup 7 ve 8 greft uygulanmadan, MDSE ile enfekte edildi ve sırasıyla bu gruplara da tigesiklin ve MKH tedavisi uygulandı. Greftler ve yumuşak doku örnekleri ameliyattan 13 gün sonra alındı. Greft çevresi dokuda koloni sayımı yapıldı. Tüm numuneler, kök hücre aktivitesini gösteren belirteçler açısından enzime bağlı bağışıklık deneyi (ELISA) ile değerlendirildi. Bulgular: Tedavilerin genel başarısı, kullanılan greftten bağımsız olarak, MDSE rekürrensi olan sıçanların sayısı ile değerlendirildi. Tedavi edilmeyen grup 2, tigesiklin grupları (3, 5 ve 7) ile MKH grupları (4, 6 ve 8) arasındaki farklılık istatistiksel olarak anlamlıydı. Mezenkimal kök hücre ve tigesiklin tedavilerinin başarısı Dakron, PTFE ve greft uygulanmayan gruplarda benzerdi. Dakron gruplarında MDSE enfeksiyonunun hem MKH hem de tigesiklin tedavisine karşı bir direnci vardı. Bu, Dakron greftlerinin enfeksiyona duyarlılığının bir göstergesi olarak kabul edildi. Ancak, grup 2 ve Dakron grupları arasında bakteriyel kolonizasyon açısından anlamlı farklılık yoktu. ELISA sonuçları üç sitokinde anlamlıydı. Sonuç: Mezenkimal kök hücreler, tek başına alternatif bir tedavi seçeneği veya vasküler greft enfeksiyonlarının kontrolü için kombine terapinin bir parçası olarak kabul edilebilir. Anahtar sözcükler: Dakron, mezenkimal kök hücreler, politetrafloroetilen, tigesiklin, vasküler greft enfeksiyonları. ABSTRACTObjectives: This study aims to evaluate the effects of mesenchymal stem cell (MSC) implantation on vascular graft infections caused by methicillinresistant Staphylococcus epidermidis (MRSE) and compare with antibiotic treatment. Materials and methods:Healthy adult 56 Wistar rats (age, over 5 months; weighing, 300-350 g) were divided into eight groups. Group 1 was defined as the control group and group 2 was defined as the infected control group. Groups 3 and 4 were defined as Dacron grafted and MRSE infected groups, treated with tigecycline and MSCs, respectively. Groups 5 and 6 were performed polytetrafluoroethylene (PTFE) graft and infected with MRSE. These groups were also administered tigecycline and MSC treatment, respectively. Groups 7 and 8 were infected with MRSE without graft administration and were also performed tigecycline and MSC treatment, respectively. Grafts and soft tissue specimens were collected at 13 days postoperatively. Colony counts of...

show abstract

Management and Outcome of Prosthetic Vascular Graft Infections: A Single Center Experience

Abstract: Prosthetic vascular graft infection needs a multidisciplinary management with appropriate antibiotherapy, radical removal of the infected graft, and in situ reconstruction. This strategy gives satisfactory results in terms of mortality, morbidity, patency rates, and infection control.

Cited by 25 publications

References 28 publications

A rare case of Listeria monocytogenes causing mycotic aneurysm of the common femoral artery: A case report

A rare case of Listeria monocytogenes causing mycotic aneurysm of the common femoral artery: A case report

Systematic Review and Meta-Analysis on the Management of Open Abdominal Aortic Graft Infections

Mesenchymal stem cells have significant anti-infective effect on methicillin-resistant Staphylococcus epidermidis vascular graft infections

Contact Info

Product

Resources

About