HIF inhibitor News Channels Access The Messages Immediately
  • Aortofemoral grafts in 8 patients were anastomosed to well-incorporated portions of the old femoral graft limbs, avoiding redo groin incisions. Repair of the intestinal defect was performed with primary anastomosis in 46 patients and with segmental bowel resection and anastomosis in 8 patients. Blood cultures were obtained in 34 patients and were positive for organisms in 15 (44%). Aortic graft cultures in 50 patients (Table IV, online only) were positive for HIF-1�� pathway organisms in 41 patients (82%), with polymicrobial infections in 34 patients (85%). The most common organisms were Streptococcus viridans in 22 patients (44%), Candida sp in 19 (38%), Lactobacillus in 13 (26%), staphylococcus coagulase-negative in 10 (20%), and Enterococcus sp in 8 (16%). Seven of 9 patients with negative graft cultures had received antibiotics for more than 7 days before the operation. There were five (9%) operative deaths. Operative mortality was 2.3% among patients who were stable at the time of their operation (1 of 44), and 40% in those who had hemorrhagic MAPK inhibitor shock (4 of 10; P < .001). The death in the stable patient occurred intraoperatively from sudden cardiovascular collapse and cardiac arrest not due to hemorrhage. Of the 4 patients with hemorrhagic shock, 1 died intraoperatively, 2 from multi-system organ failure at 1 and 81 days after operation, and the other from disseminated intravascular coagulation the day after ISRG replacement. Risk factors for operative death (P < .05) on univariate analysis were hemorrhagic shock (40% vs 2.3%), emergency operation (31% vs 0%), female gender (22% vs 6.6%), and perigraft purulence (33% vs 4.4%). Independent predictors (P < .01) for operative mortality on multivariate analysis were hemorrhagic shock (odds ratio, 16; 95% confidence interval, 3-200) and female gender (odds ratio, 15; 95% confidence interval, 1.3-184). Postoperative complications occurred in 28 patients (52%; Table V). The most common complications were acute renal insufficiency in 9 patients (17%), 4 of whom needed temporary dialysis, respiratory insufficiency in 7 patients (13%), which resulted in tracheostomy in 5 patients, and wound problems in 6 patients (11%). Early vascular problems occurred in 5 patients, including graft limb occlusion requiring thrombectomy in 2 patients, and compartment oxyclozanide syndrome, atheroembolization, and iliac vein injury in 1 patient each. The average length of stay in the hospital was 20 �� 18 days. All patients completed a 4- to 8-week course of IV antibiotics, and 44 patients (90%) received oral antibiotic suppression (Table VI, online only). The mean follow-up was 51 months (range, 3-197 months). Of the 49 patients who were available for follow-up, 46 (94%) had repeat CTs and 15 (31%) had In-WBC scans of the aortic graft. Patient survival at 1 year, 5 years, and 10 years was 85 �� 5%, 59 �� 8%, and 40 �� 9%, respectively, significantly less (P < .

Howdy, Stranger!

It looks like you're new here. If you want to get involved, click one of these buttons!