| In situ repair of mycotic abdominal aortic aneurysms with rifampin-bonded gelatin-impregnated Dacron grafts: a preliminary case report. | |
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MedLine Citation:
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PMID: 8808970 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Treatment of mycotic aortic aneurysm by excision and extraanatomic bypass is difficult to apply when the infectious process involves the visceral arteries. On the basis of experimental studies in our laboratory that demonstrated prolonged antistaphylococcal activity of rifampin-bonded, gelatin-impregnated Dacron grafts after implantation in the arterial circulation, this conduit was successfully used for in situ replacement of a native aortic infection in two patients. Both patients had fever, leukocytosis, abdominal or back pain, and a computed tomographic scan that demonstrated contained rupture of a mycotic aneurysm. Preoperative computed tomography-guided aspiration and culture of periaortic fluid from one patient grew Staphylococcus aureus. Treatment consisted of prolonged (6 weeks) culture-specific parenteral antibiotic therapy, excision of involved aorta, oxychlorosene irrigation of the aortic bed, and restoration of aortic continuity by in situ prosthetic replacement. A preliminary right axillobifemoral bypass was performed in the patient who had an infection involving the suprarenal and infrarenal aorta. In both patients intraoperative culture of aorta wall recovered S. aureus. Patients were discharged at 20 and 21 days. Clinical follow-up and computed tomographic imaging of the replacement graft beyond 10 months after surgery demonstrated no signs of residual aortic infection. In the absence of gross pus and frank sepsis, the use of an antibiotic-bonded prosthetic graft with antistaphylococcal activity should be considered in patients who have arterial infections caused by S. aureus when excision and ex situ bypass are not feasible. |
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Authors:
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A K Gupta; D F Bandyk; B L Johnson |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of vascular surgery Volume: 24 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 1996 Sep |
Date Detail:
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Created Date: 1996-10-22 Completed Date: 1996-10-22 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 472-6 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of South Florida College of Medicine, Tampa, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aneurysm, Infected / radiography, surgery* Anti-Bacterial Agents / administration & dosage* Aorta, Abdominal / radiography, surgery Aortic Aneurysm, Abdominal / radiography, surgery* Blood Vessel Prosthesis* Female Gelatin Humans Male Polyethylene Terephthalates Rifampin / administration & dosage* Staphylococcal Infections / drug therapy, surgery* Tomography, X-Ray Computed Vascular Surgical Procedures / methods |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Polyethylene Terephthalates; 13292-46-1/Rifampin; 9000-70-8/Gelatin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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