Niaz O S, Rao A, Carey D, Refson J R, Abidia A, Somaiya P
Department of Vascular Surgery, Princess Alexandra Hospital, Harlow CM20 1QX, UK.
Int J Vasc Med. 2020 Jan 31;2020:9574734. doi: 10.1155/2020/9574734. eCollection 2020.
. Aortic graft infection (AGI) is a rare complication following AAA repair and is associated with high morbidity and mortality. Management is variable, and there are no evidence-based guidelines. The aim of this study was to systematically review and analyse management options for AGI.
Data was collected between July and August 2018. A full HDAS search was conducted on the following databases: MEDLINE, EMBASE, CINAHL, and PUBMED. Meta-analysis was conducted using RevMan 5 software.
1,365 patient outcomes were assessed (10 cohort studies and 12 comparative studies). The most common treatment was in situ replacement of the graft (ISR) followed by extra-anatomical replacement (EAR). Various grafts were used for ISR, such as fresh/cryopreserved allograft, venous graft, and prosthetic grafts. No graft material was shown to be superior. Axillobifemoral graft was the commonest type of EAR used. In the majority of cohort studies, ISR was the main treatment for AGI. There was no significant difference in the overall mortality rate (ISR = 70/176 vs. EAR = 70/176 vs. EAR = 0.87). Graft occlusion rate was significantly lower in the ISR group vs. the EAR group ( = 70/176 vs. EAR = 70/176 vs. EAR = 0.87). Graft occlusion rate was significantly lower in the ISR group vs. the EAR group ( = 70/176 vs. EAR = 70/176 vs. EAR = 0.87). Graft occlusion rate was significantly lower in the ISR group vs. the EAR group (. In situ replacement is the preferred method of treatment as it had lower rates of occlusion. Further strong evidence is required, such as a multicentre trial to establish a management pathway for the condition.
主动脉移植物感染（AGI）是腹主动脉瘤修复术后一种罕见的并发症，与高发病率和死亡率相关。治疗方法多样，且尚无循证指南。本研究的目的是系统评价和分析AGI的治疗选择。
于2018年7月至8月收集数据。对以下数据库进行了全面的HDAS检索：MEDLINE、EMBASE、CINAHL和PUBMED。使用RevMan 5软件进行荟萃分析。
评估了1365例患者的结局（10项队列研究和12项比较研究）。最常见的治疗方法是原位更换移植物（ISR），其次是解剖外更换（EAR）。ISR使用了各种移植物，如新鲜/冷冻保存的同种异体移植物、静脉移植物和人工移植物。没有一种移植物材料显示出优越性。腋股双腔移植物是最常用的EAR类型。在大多数队列研究中，ISR是AGI的主要治疗方法。总体死亡率无显著差异（ISR = 70/176 vs. EAR = 70/176 vs. EAR = 0.87）。ISR组的移植物闭塞率显著低于EAR组（= 70/176 vs. EAR = 70/176 vs. EAR = 0.87）。ISR组的移植物闭塞率显著低于EAR组（= 70/176 vs. EAR = 70/176 vs. EAR = 0.87）。ISR组的移植物闭塞率显著低于EAR组（。原位更换是首选的治疗方法，因为其闭塞率较低。需要进一步的有力证据，如多中心试验，以建立针对该病症的管理途径。
