Session Spotlights Infection in Aneurysms, Grafts, and Endografts

 

The ongoing discussion over the optimal management of infection in aneurysms and grafts takes center stage in the session, “New Developments in the Treatment of Infected Aneurysms, Prosthetic Arterial Grafts, and Aortic Endografts,” on Friday morning. The session includes two debates: one on mycotic abdominal aortic aneurysms and what to do about them, and the other on the optimal techniques for handling infected aortic grafts and endografts.

“The management of infected aortic grafts is challenging and controversial,” according to Dr. Keith Calligaro, co-moderator of the session. Different aspects of treatment will be discussed, said Dr. Calligaro, chief of the section of vascular surgery and endovascular therapy at Pennsylvania Hospital, and clinical professor of surgery, University of Pennsylvania School of Medicine.

“Vascular surgeons’ practices will be influenced because of the difficult nature of treating these complicated cases, including total graft excision and partial or complete graft preservation,” said Dr. Calligaro.

The session begins with a presentation suggesting a change in practice, “With Mycotic AAAs There Has Been a Paradigm Shift in Treatment: A Propensity Matched Multicenter Study Shows That EVAR Is Better than Open Repair as a Durable or Bridge Treatment,” by Dr. Anders Wanhainen, professor of surgery at Uppsala University. Dr. Wanhainen is followed by Dr. Manju Kalra, professor, Mayo Clinic College of Medicine, speaking on “Intraabdominal Extra-Anatomic Bypass for Para- Or Supra-Renal Aortic Infections: Techniques and Results.” Dr. Fred A. Weaver, professor of surgery, Keck School of Medicine at the University of Southern California, then delves into the role of endovascular aortic aneurysm repair (EVAR) for mycotic AAAs.

Next, then the session gears up for a debate, with Dr. Boonprasit Kritpracha, instructor and vascular surgeon, Prince of Songkla University in Thailand, taking the side of “EVAR Should Be the First Choice in Treating Mycotic AAAs: Based on a 10-Year Experience.” Dr. Kritpracha is followed by session co-moderator Dr. Thomas C. Bower, professor of surgery, Mayo Clinic College of Medicine and Science, who takes the view, “Not So: Why Open Repair Should Be the First Choice in Treating Most Mycotic AAAs.”

A talk on the neoaortoiliac system (NAIS) procedure for the treatment of the infected aortic graft, “Technical Tips for Facilitating Deep Vein Grafts for Aortoiliac Arterial and Graft Infections,” by Dr. James H. Black, III, The David Goldfarb, MD Associate Professor of Surgery, The Johns Hopkins University School of Medicine, completes the first half of the session.

The next part of the session focuses on arterial graft and endograft infections. Dr. Max Zegelman, professor of surgery at JWG-University Frankfurt, begins with a review of new techniques for the in situ repair of infected prosthetic arterial grafts and the impact of negative pressure wound therapy.

The presentations are followed by a second debate on the topic of removal vs. saving of infected aortic grafts and endografts. Dr. Colin D. Bicknell, clinical senior lecturer, Imperial College, takes the side of “Definitive Excisional Graft Removal Is a Must for All Infected Aortic Grafts and Endografts,” while co-moderator Dr. Calligaro takes the side of “Not So: More Conservative Graft Saving May Sometimes Be the Best Treatment for infected Aortic Grafts and Endografts if Certain Technical Steps and Adjuncts Are Used.”

“The take-home message is that, in general, total graft excision of infected intracavitary prosthetic and endovascular aortic grafts is recommended, but the surgeon needs to be aware that in certain cases, partial or complete graft preservation may be a better option,” Dr. Calligaro said.

The session continues with more on the topic of treating infected endografts. Dr. Kamphol Laohapensang, professor of vascular surgery, Chiang Mai University Hospital in Thailand, will focus on treating infected endografts after EVAR and under what circumstances endografts are effective for treating mycotic AAAs.

 

The ongoing discussion over the optimal management of infection in aneurysms and grafts takes center stage in the session, “New Developments in the Treatment of Infected Aneurysms, Prosthetic Arterial Grafts, and Aortic Endografts,” on Friday morning. The session includes two debates: one on mycotic abdominal aortic aneurysms and what to do about them, and the other on the optimal techniques for handling infected aortic grafts and endografts.

“The management of infected aortic grafts is challenging and controversial,” according to Dr. Keith Calligaro, co-moderator of the session. Different aspects of treatment will be discussed, said Dr. Calligaro, chief of the section of vascular surgery and endovascular therapy at Pennsylvania Hospital, and clinical professor of surgery, University of Pennsylvania School of Medicine.

“Vascular surgeons’ practices will be influenced because of the difficult nature of treating these complicated cases, including total graft excision and partial or complete graft preservation,” said Dr. Calligaro.

The session begins with a presentation suggesting a change in practice, “With Mycotic AAAs There Has Been a Paradigm Shift in Treatment: A Propensity Matched Multicenter Study Shows That EVAR Is Better than Open Repair as a Durable or Bridge Treatment,” by Dr. Anders Wanhainen, professor of surgery at Uppsala University. Dr. Wanhainen is followed by Dr. Manju Kalra, professor, Mayo Clinic College of Medicine, speaking on “Intraabdominal Extra-Anatomic Bypass for Para- Or Supra-Renal Aortic Infections: Techniques and Results.” Dr. Fred A. Weaver, professor of surgery, Keck School of Medicine at the University of Southern California, then delves into the role of endovascular aortic aneurysm repair (EVAR) for mycotic AAAs.

Next, then the session gears up for a debate, with Dr. Boonprasit Kritpracha, instructor and vascular surgeon, Prince of Songkla University in Thailand, taking the side of “EVAR Should Be the First Choice in Treating Mycotic AAAs: Based on a 10-Year Experience.” Dr. Kritpracha is followed by session co-moderator Dr. Thomas C. Bower, professor of surgery, Mayo Clinic College of Medicine and Science, who takes the view, “Not So: Why Open Repair Should Be the First Choice in Treating Most Mycotic AAAs.”

A talk on the neoaortoiliac system (NAIS) procedure for the treatment of the infected aortic graft, “Technical Tips for Facilitating Deep Vein Grafts for Aortoiliac Arterial and Graft Infections,” by Dr. James H. Black, III, The David Goldfarb, MD Associate Professor of Surgery, The Johns Hopkins University School of Medicine, completes the first half of the session.

The next part of the session focuses on arterial graft and endograft infections. Dr. Max Zegelman, professor of surgery at JWG-University Frankfurt, begins with a review of new techniques for the in situ repair of infected prosthetic arterial grafts and the impact of negative pressure wound therapy.

The presentations are followed by a second debate on the topic of removal vs. saving of infected aortic grafts and endografts. Dr. Colin D. Bicknell, clinical senior lecturer, Imperial College, takes the side of “Definitive Excisional Graft Removal Is a Must for All Infected Aortic Grafts and Endografts,” while co-moderator Dr. Calligaro takes the side of “Not So: More Conservative Graft Saving May Sometimes Be the Best Treatment for infected Aortic Grafts and Endografts if Certain Technical Steps and Adjuncts Are Used.”

“The take-home message is that, in general, total graft excision of infected intracavitary prosthetic and endovascular aortic grafts is recommended, but the surgeon needs to be aware that in certain cases, partial or complete graft preservation may be a better option,” Dr. Calligaro said.

The session continues with more on the topic of treating infected endografts. Dr. Kamphol Laohapensang, professor of vascular surgery, Chiang Mai University Hospital in Thailand, will focus on treating infected endografts after EVAR and under what circumstances endografts are effective for treating mycotic AAAs.

 

The ongoing discussion over the optimal management of infection in aneurysms and grafts takes center stage in the session, “New Developments in the Treatment of Infected Aneurysms, Prosthetic Arterial Grafts, and Aortic Endografts,” on Friday morning. The session includes two debates: one on mycotic abdominal aortic aneurysms and what to do about them, and the other on the optimal techniques for handling infected aortic grafts and endografts.

“The management of infected aortic grafts is challenging and controversial,” according to Dr. Keith Calligaro, co-moderator of the session. Different aspects of treatment will be discussed, said Dr. Calligaro, chief of the section of vascular surgery and endovascular therapy at Pennsylvania Hospital, and clinical professor of surgery, University of Pennsylvania School of Medicine.

“Vascular surgeons’ practices will be influenced because of the difficult nature of treating these complicated cases, including total graft excision and partial or complete graft preservation,” said Dr. Calligaro.

The session begins with a presentation suggesting a change in practice, “With Mycotic AAAs There Has Been a Paradigm Shift in Treatment: A Propensity Matched Multicenter Study Shows That EVAR Is Better than Open Repair as a Durable or Bridge Treatment,” by Dr. Anders Wanhainen, professor of surgery at Uppsala University. Dr. Wanhainen is followed by Dr. Manju Kalra, professor, Mayo Clinic College of Medicine, speaking on “Intraabdominal Extra-Anatomic Bypass for Para- Or Supra-Renal Aortic Infections: Techniques and Results.” Dr. Fred A. Weaver, professor of surgery, Keck School of Medicine at the University of Southern California, then delves into the role of endovascular aortic aneurysm repair (EVAR) for mycotic AAAs.

Next, then the session gears up for a debate, with Dr. Boonprasit Kritpracha, instructor and vascular surgeon, Prince of Songkla University in Thailand, taking the side of “EVAR Should Be the First Choice in Treating Mycotic AAAs: Based on a 10-Year Experience.” Dr. Kritpracha is followed by session co-moderator Dr. Thomas C. Bower, professor of surgery, Mayo Clinic College of Medicine and Science, who takes the view, “Not So: Why Open Repair Should Be the First Choice in Treating Most Mycotic AAAs.”

A talk on the neoaortoiliac system (NAIS) procedure for the treatment of the infected aortic graft, “Technical Tips for Facilitating Deep Vein Grafts for Aortoiliac Arterial and Graft Infections,” by Dr. James H. Black, III, The David Goldfarb, MD Associate Professor of Surgery, The Johns Hopkins University School of Medicine, completes the first half of the session.

The next part of the session focuses on arterial graft and endograft infections. Dr. Max Zegelman, professor of surgery at JWG-University Frankfurt, begins with a review of new techniques for the in situ repair of infected prosthetic arterial grafts and the impact of negative pressure wound therapy.

The presentations are followed by a second debate on the topic of removal vs. saving of infected aortic grafts and endografts. Dr. Colin D. Bicknell, clinical senior lecturer, Imperial College, takes the side of “Definitive Excisional Graft Removal Is a Must for All Infected Aortic Grafts and Endografts,” while co-moderator Dr. Calligaro takes the side of “Not So: More Conservative Graft Saving May Sometimes Be the Best Treatment for infected Aortic Grafts and Endografts if Certain Technical Steps and Adjuncts Are Used.”

“The take-home message is that, in general, total graft excision of infected intracavitary prosthetic and endovascular aortic grafts is recommended, but the surgeon needs to be aware that in certain cases, partial or complete graft preservation may be a better option,” Dr. Calligaro said.

The session continues with more on the topic of treating infected endografts. Dr. Kamphol Laohapensang, professor of vascular surgery, Chiang Mai University Hospital in Thailand, will focus on treating infected endografts after EVAR and under what circumstances endografts are effective for treating mycotic AAAs.