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A Meta-Analysis of Outcomes After In Situ Reconstructions for Aortic Graft Infection

Abstract : Objective - To confirm the advantage of in situ reconstruction (ISR) over extra-anatomic reconstruction (EAR) for aortic graft infection and determine the most appropriate conduit including autogenous veins, cryopreserved allografts, and synthetic prosthesis (standard, rifampicin of silver polyesters).

Methods - A meta-analysis was conducted with rate of mortality, graft occlusion, amputation, and reinfection. A meta-regression was performed with 4 factors: patients' age, presence of prosthetic-duodenal fistula (PDF), virulent organisms, or nonvirulent organisms.

Results - In situ reconstruction over EAR seems to favor all events. For the 5 conduits used for ISR, according to operative mortality, age of the patients looks to have a positive correlation only for silver polyester and no conduit present any advantage in the presence of PDF. Reinfection seems to be not significantly different for the 5 conduits, and only autogenous veins appear to have a positive correlation with infecting organisms.

Conclusion - In situ reconstruction may be considered as first-line treatment. Our results suggest that silver polyesters appear to be most appropriate for older patients, and in order to limit reinfection, autogenous veins are probably the most suitable conduit.
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Contributor : Laurent Jonchère <>
Submitted on : Thursday, April 19, 2018 - 2:52:09 PM
Last modification on : Tuesday, June 15, 2021 - 3:07:11 AM



Michel Batt, Patrick Feugier, Fabrice Camou, Amandine Coffy, Eric Senneville, et al.. A Meta-Analysis of Outcomes After In Situ Reconstructions for Aortic Graft Infection. Angiology, SAGE Publications, 2018, 69 (5), pp.370-379. ⟨10.1177/0003319717710114⟩. ⟨hal-01771414⟩



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