Document Detail


Perigraft air, fever, and leukocytosis after endovascular repair of abdominal aortic aneurysms.
MedLine Citation:
PMID:  10527435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The postimplantation syndrome of fever and leukocytosis after endovascular repair of infrarenal aortic aneurysms has not been previously characterized and its etiology is not known. METHODS: We studied the first 12 patients who underwent successful endovascular repair of infrarenal aortic aneurysms with Dacron-covered stent-grafts, as part of an ongoing phase II clinical trial. Sepsis syndrome evaluations (physical examination, urinalysis, chest radiograph, urine cultures, and blood cultures) were performed for all patients with postoperative temperature (T) greater than 101.4 degrees F. Computed tomography scans of the abdomen were performed, as part of the clinical protocol, on postoperative days 2 and 30. RESULTS: Fever (T > 101.4 degrees F) was seen in 8 of 12 (67%) patients (P < 05). An additional 2 of 12 (17%) patients had low-grade fevers (100.3 degrees F, 100.6 degrees F). Only 2 of 12 (17%) patients remained afebrile postoperatively. Leukocytosis with counts over 11,000 white blood cells (WBC)/dL was observed in 7 of 12 (58%) patients (P < 05). Sepsis evaluations failed to identify any source of infection in 11 of 12 (97%) patients. Computed tomography scan evidence of perigraft air was noted in 8 of 12 (67%) patients. All patients were afebrile, had normal white blood cell counts, and were discharged within 1 week postoperatively. There has been no evidence of graft infection after 1 to 6 months of follow-up. CONCLUSIONs: Fever and leukocytosis after stent-graft repair of aortic aneurysms does not represent evidence of systemic or graft infection and is not clearly related to nonspecific causes of postoperative fever and leukocytosis. Moreover, the finding of early postoperative perigraft air is not necessarily an indication of graft infection even when concurrently present with fever and leukocytosis.
Authors:
O C Velázquez; J P Carpenter; R A Baum; C F Barker; M Golden; F Criado; A Pyeron; R M Fairman
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study    
Journal Detail:
Title:  American journal of surgery     Volume:  178     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-04     Completed Date:  1999-11-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  185-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Air
Aortic Aneurysm, Abdominal / surgery*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation*
Fever / etiology
Humans
Leukocytosis / etiology
Polyethylene Terephthalates
Postoperative Complications / etiology*
Retrospective Studies
Stents*
Chemical
Reg. No./Substance:
0/Polyethylene Terephthalates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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