Early Outcomes of In-situ Aortoiliac Reconstruction in Infected Abdominal Aortic Aneurysm: Experience in Samutsakhon Hospital
Keywords:
Infected abdominal aortic aneurysm, In-situ aortoiliac reconstructionAbstract
Background: Infected abdominal aortic aneurysm (IAAA) is a rare and life-threatening condition, constituting less than 2% of all abdominal aorto-iliac aneurysms, with significant morbidity and mortality risks due to its potential for rupture and sepsis1,2 In-situ aortoiliac reconstruction stands as the primary surgical approach, designed to eradicate infection, stabilize hemodynamics, and restore lower limb perfusion effectively.
Objective: This study aims to evaluate the early outcomes (up to 6 months) of open in-situ aortoiliac reconstruction in a single-center cohort of 10 IAAA patients at Samutsakhon Hospital, focusing on surgical feasibility, safety, and comprehensive perioperative care.
Methods: A retrospective case series analyzed 10 patients with confirmed IAAA who underwent open in-situ reconstruction between January 2020 and December 2024. Detailed data were collected, including patient demographics, clinical presentations, operative procedures, and postoperative outcomes, with an emphasis on radiological and microbiological assessments.
Results: The average operative time was 171.5 minutes (range 95–260 minutes), with a mean blood loss of 1,830 mL (range 300–4,000 mL). Patients spent an average of 3 days in the intensive care unit (ICU) (range 1–7 days) and 8.9 days in the hospital (range 4–16 days). Complications occurred in 30% of cases, including two intraoperative inferior vena cava (IVC) injuries repaired immediately and one postoperative acute kidney injury. Survival rates were 100% in-hospital, at 30 days, 3 months, and 6 months, with no graft reinfections reported.
Conclusion: In-situ aortoiliac reconstruction proves to be a highly effective and practical surgical option for IAAA, delivering excellent early outcomes with zero mortality and no graft reinfections up to 6 months, thus affirming its status as the preferred treatment for surgically eligible patients
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