Spiral Vein Reconstruction of the Infected Abdominal Aorta Using the Greater Saphenous Vein: Preliminary Results of the Tilburg Experience

• Published in: European journal of vascular and endovascular surgery 2011-05, Vol.41 (5), p.637-646
• Main Authors: van Zitteren, M, van der Steenhoven, T.J, Burger, D.H.C, van Berge Henegouwen, D.P, Heyligers, J.M.M, Vriens, P.W.H.E
• Format: Article
• Language: English
• Subjects: Aged; Aneurysm, Infected - diagnosis; Aneurysm, Infected - mortality; Aneurysm, Infected - surgery; Aorta; Aortic Aneurysm, Abdominal - diagnosis; Aortic Aneurysm, Abdominal - mortality; Aortic Aneurysm, Abdominal - surgery; Arterial reconstruction; Biopsy, Fine-Needle; Blood Vessel Prosthesis Implantation - methods; Female; Follow-Up Studies; Greater saphenous vein; Hospital Mortality - trends; Humans; Infected aneurysm; Infected graft; Male; Netherlands - epidemiology; Positron-Emission Tomography; Retrospective Studies; Saphenous Vein - transplantation; Spiral vein; Surgery; Survival Rate - trends; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2011.01.020

Abstract Objectives The aim of this study was to evaluate patients, who underwent spiral vein reconstruction of the abdominal aorta to repair infected aneurysms or replace infected aortic grafts. Methods All spiral vein reconstructions between March 2005 and May 2010 because of vascular infections of the abdominal aorta were retrospectively included. Diagnosis was determined by clinical examination, laboratory results, computed tomography (CT) and positron emission tomography (PET) scan, and microbiological tests. Spiral vein reconstruction consisted of harvesting the greater saphenous vein (GSV) and construction into a spiral graft, aortic reconstruction and a transmesenteric omentumplasty. Primary outcomes were survival and limb salvage. Secondary outcomes included technical, clinical and ongoing success, re-infection, ongoing infection and patency. Results All five patients survived surgery, and there were no in-hospital deaths. Survival and limb salvage were 100% after median follow-up of 13 months (6–67 months). Further, technical, clinical and continuing success was 100%. There were no re-infections or ongoing infections. Conclusions Spiral vein reconstruction using the GSV showed good short-term survival and limb salvage. It, therefore, might be considered as an attractive treatment method for vascular infections of the abdominal aorta. Still, more follow-up is needed to evaluate long-term results.