1
|
Matsubara Y, Kawanami S, Kinoshita G, Kurose S, Shinichiro Y, Morisaki K, Furuyama T, Yoshizumi T. Perioperative therapeutic antibiotics are beneficial to prevent exacerbation of limb-associated infection after bypass surgery in patients with critical limb-threatening ischemia and foot infection score of ≥1. Vascular 2024; 32:640-647. [PMID: 36719423 DOI: 10.1177/17085381231154608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Postoperative limb infection is associated with a poor prognosis and a low amputation-free survival rate after surgical revascularization in patients with critical limb-threatening ischemia. The Global Vascular Guidelines 2019 recommend antibiotic therapy for patients with deep space foot infection or wet gangrene; however, no study is cited as evidence for this recommendation. The present study was performed to offer new evidence supporting the use of perioperative therapeutic antibiotics in patients with critical limb-threatening ischemia (CLTI) undergoing surgical revascularization. METHODS This single-center retrospective study was performed in Kyushu University Hospital and involved patients with CLTI who underwent surgical revascularization from 2003 to 2021. Ampicillin/sulbactam and cefazolin were defined as preventive antibiotics, and other types were defined as therapeutic antibiotics. Postoperative limb-associated infection was defined as an increased foot infection (fI) score in the Wound, Ischemia, and foot Infection (WIfI) classification system after surgical revascularization. The association between perioperative antibiotic therapy and postoperative limb-associated infection was assessed. RESULTS Among 286 limbs of 263 patients with CLTI, 27 (9%) limbs developed postoperative limb-associated infection after surgical revascularization. The fI scores were significantly higher in the patients with than without postoperative limb-associated infection (1.0 ± 0.2 vs 0.4 ± 0.1, respectively; p = 0.0033), indicating that an fI score of ≥1 was a risk factor for postoperative limb-associated infection. Perioperative therapeutic antibiotics significantly reduced the incidence of postoperative limb-associated infection compared with preventive antibiotics (0.0% vs. 44.8%, respectively; p = 0.0028) in the patients with CLTI who had an fI score of ≥1 after bypass surgery, although perioperative therapeutic antibiotics were not effective for patients with an fI score of 0. CONCLUSION Perioperative therapeutic antibiotics for patients with an fI score of ≥1 are beneficial for reducing the incidence of postoperative limb-associated infection after surgical revascularization.
Collapse
Affiliation(s)
- Yutaka Matsubara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shogo Kawanami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Go Kinoshita
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shun Kurose
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Vascular Surgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - Yoshino Shinichiro
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Japan
| | - Koichi Morisaki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tadashi Furuyama
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
2
|
Gunawardena M, Salami M, Howard A, Awupetu A. Does the Mode of Anaesthesia (General or Regional) Affect Survival and Complications Following Femoropopliteal and Femorodistal Bypass? Cureus 2022; 14:e32104. [DOI: 10.7759/cureus.32104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/04/2022] Open
|
3
|
Effects of protective mechanical ventilation during general anesthesia in patients undergoing peripheral vascular surgery: A randomized controlled trial. J Clin Anesth 2019; 61:109656. [PMID: 31784303 DOI: 10.1016/j.jclinane.2019.109656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/30/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
|
4
|
The Relationship between Hospital or Surgeon Volume and Outcomes in Lower Limb Vascular Surgery in the United Kingdom and Europe. Ann Vasc Surg 2017; 45:271-286. [DOI: 10.1016/j.avsg.2017.04.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/25/2017] [Indexed: 11/22/2022]
|
5
|
Takahashi Y, Sato T, Okazaki H, Nozaki A, Matsushita M, Kamiya M, Shimizu W. Transvenous Intravascular Ultrasound-Guided Endovascular Treatment for Chronic Total Occlusion of the Infrainguinal Arteries. J Endovasc Ther 2017; 24:718-726. [PMID: 28766400 DOI: 10.1177/1526602817723139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To investigate the 1-year outcomes of transvenous intravascular ultrasound (IVUS)-guided endovascular therapy (EVT) for chronic total occlusion (CTO) of the lower extremity arteries. METHODS Transvenous IVUS-guided EVT was performed in 44 patients (50 limbs) with CTO of the femoropopliteal arteries or tibioperoneal trunk. Treatment involved crossing a guidewire through the CTO under the guidance of both fluoroscopic and IVUS imaging, along with insertion of the IVUS catheter into a vein parallel to the target artery. Primary success rate, complications, and target lesion revascularization (TLR) at 12-month follow-up were investigated. RESULTS Successful recanalization, defined as grade 3 flow (Thrombolysis in Myocardial Infarction score) and no flow-limiting dissection, was observed in 48 (96%) limbs. Two limbs with failed recanalization had a very long CTO lesion from the superficial femoral artery to below the knee. A bidirectional approach was selected in 11 (22%) limbs. Complications at the access site occurred in only 2 patients. The rate of freedom from TLR at 12 months was 77.9% (95% confidence interval 61.4 to 87.9). CONCLUSION Transvenous IVUS-guided EVT is safe and can provide optimal short-term results for EVT of CTO in the infrainguinal arteries. IVUS-guided EVT may be one of the most effective treatment strategies for CTO of the femoropopliteal arteries or tibioperoneal trunk.
Collapse
Affiliation(s)
| | - Taisuke Sato
- 1 Department of Cardiology, Fraternity Memorial Hospital, Tokyo, Japan
| | - Hirotake Okazaki
- 1 Department of Cardiology, Fraternity Memorial Hospital, Tokyo, Japan
| | - Ayaka Nozaki
- 1 Department of Cardiology, Fraternity Memorial Hospital, Tokyo, Japan
| | - Masato Matsushita
- 1 Department of Cardiology, Fraternity Memorial Hospital, Tokyo, Japan
| | - Masataka Kamiya
- 1 Department of Cardiology, Fraternity Memorial Hospital, Tokyo, Japan
| | - Wataru Shimizu
- 2 Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
6
|
Kehlet M, Jensen LP, Schroeder TV. Risk Factors for Complications after Peripheral Vascular Surgery in 3,202 Patient Procedures. Ann Vasc Surg 2016; 36:13-21. [DOI: 10.1016/j.avsg.2016.02.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 01/20/2016] [Accepted: 02/17/2016] [Indexed: 12/14/2022]
|
7
|
Brahmbhatt R, Brewster LP, Shafii S, Rajani RR, Veeraswamy R, Salam A, Dodson TF, Arya S. Gender and frailty predict poor outcomes in infrainguinal vascular surgery. J Surg Res 2016; 201:156-65. [DOI: 10.1016/j.jss.2015.10.026] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/09/2015] [Accepted: 10/14/2015] [Indexed: 02/07/2023]
|
8
|
Reifsnyder T, Arhuidese IJ, Hicks CW, Obeid T, Massada KE, Khaled A, Qazi U, Malas MB. Contemporary Outcomes for Open Infrainguinal Bypass in the Endovascular Era. Ann Vasc Surg 2016; 30:52-8. [DOI: 10.1016/j.avsg.2015.10.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 09/09/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
|
9
|
Sinnamon AJ, Sonnenberg EM, Bartlett EK, Meise CK, Wang GJ, Kelz RR. The influence of socioeconomic factors on gender disparities in lower extremity bypass. J Surg Res 2014; 188:537-44. [DOI: 10.1016/j.jss.2014.01.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/21/2014] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
|
10
|
Healy D, Boyle E, Clarke Moloney M, Hodnett P, Scanlon T, Grace P, Walsh S. Contrast-enhanced magnetic resonance angiography in diabetic patients with infra-genicular peripheral arterial disease: Systematic review. Int J Surg 2013; 11:228-32. [DOI: 10.1016/j.ijsu.2013.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 01/08/2013] [Accepted: 02/02/2013] [Indexed: 10/27/2022]
|
11
|
Affiliation(s)
- David Paul Slovut
- From the Divisions of Cardiology (D.P.S.) and Vascular and Endovascular Surgery (D.P.S., E.C.L.), Montefiore Medical Center, Bronx, NY
| | - Evan C. Lipsitz
- From the Divisions of Cardiology (D.P.S.) and Vascular and Endovascular Surgery (D.P.S., E.C.L.), Montefiore Medical Center, Bronx, NY
| |
Collapse
|
12
|
Seymour KA, Sadowitz B, Amankwah KS, Gahtan V. Outcome of lower extremity revascularization for peripheral artery occlusive disease: is there a difference between men and women? Vascular 2011; 19:59-67. [DOI: 10.1258/vasc.2010.ra0042] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The incidence of peripheral arterial occlusive disease (PAD) increases with age. Women represent a growing percentage of the elderly population who present with PAD. While speculation exists that gender affects outcome after revascularization procedures, the literature is confusing and often conflicting. This review compares outcomes by gender after open surgical and endovascular lower extremity revascularization (LER) procedures including: demographic differences, patency rates, limb salvage rates, long-term survival, perioperative complications and 30-day mortality. This review summarizes the existing data and discusses current influences on outcome after LER.
Collapse
Affiliation(s)
- Keri A Seymour
- Division of Vascular Surgery and Endovascular Services, SUNY Upstate Medical University, 750 East Adams Street
- Department of Veterans Affairs, VA Healthcare Network Upstate New York at Syracuse, 800 Irving Avenue, Syracuse, NY 13210, USA
| | - Benjamin Sadowitz
- Division of Vascular Surgery and Endovascular Services, SUNY Upstate Medical University, 750 East Adams Street
- Department of Veterans Affairs, VA Healthcare Network Upstate New York at Syracuse, 800 Irving Avenue, Syracuse, NY 13210, USA
| | - Kwame S Amankwah
- Division of Vascular Surgery and Endovascular Services, SUNY Upstate Medical University, 750 East Adams Street
- Department of Veterans Affairs, VA Healthcare Network Upstate New York at Syracuse, 800 Irving Avenue, Syracuse, NY 13210, USA
| | - Vivian Gahtan
- Division of Vascular Surgery and Endovascular Services, SUNY Upstate Medical University, 750 East Adams Street
- Department of Veterans Affairs, VA Healthcare Network Upstate New York at Syracuse, 800 Irving Avenue, Syracuse, NY 13210, USA
| |
Collapse
|