Rifampin soaking Dacron-based endografts for implantation in infected aortic aneurysms - New application of a time-tested principle

Guillermo A. Escobar, Jonathan L. Eliason, Justin Hurie, Shipra Arya, John E. Rectenwald, Dawn M. Coleman

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Infections involving the aorta are associated with high rates of morbidity and mortality, and their management is complex. Saturating Dacron grafts in rifampin (60 mg/mL) inhibits the growth of organisms commonly found to be involved in both primary aortic infections and aortoenteric fistulas. Open repair and replacement of the aorta with rifampin-soaked Dacron grafts is frequently used in clinical practice and is considered a viable option for open repair with a low recurrence of infection; however, the morbidity and mortality of the procedure is significant. More recently, patients who are high risk for open surgery have been managed with endografts to treat infected aortas and aortoenteric fistulas with limited success, a high recurrence rate, and elevated mortality. We describe a technique to expose Dacron endografts with rifampin delivered via injection port or into the sheath before deployment in selected patients with aortic infections. We used this novel technique in 2 patients who were high risk for open repair: 1 with a bleeding aortoenteric fistula and 1 with mycotic abdominal aortic aneurysm. The first patient tolerated 1.5 years without surgical correction of the duodenal defect after placement of a rifampin-treated endograft. This allowed her to recover and ultimately undergo definitive repair under elective circumstances. Our second patient remains without evidence of recurrence 1 year after implantation for a mycotic abdominal aortic aneurysm. Following the principles of rifampin use in open vascular repairs, treating Dacron endografts with rifampin may add similar antimicrobial resistance when used to treat selected aortic infections.

Original languageEnglish (US)
Pages (from-to)744-748
Number of pages5
JournalAnnals of Vascular Surgery
Volume28
Issue number3
DOIs
StatePublished - Jan 1 2014

Fingerprint

Infected Aneurysm
Polyethylene Terephthalates
Aortic Aneurysm
Rifampin
Fistula
Aorta
Infection
Abdominal Aortic Aneurysm
Recurrence
Mortality
Morbidity
Transplants
Blood Vessels
Hemorrhage
Injections
Growth

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Rifampin soaking Dacron-based endografts for implantation in infected aortic aneurysms - New application of a time-tested principle. / Escobar, Guillermo A.; Eliason, Jonathan L.; Hurie, Justin; Arya, Shipra; Rectenwald, John E.; Coleman, Dawn M.

In: Annals of Vascular Surgery, Vol. 28, No. 3, 01.01.2014, p. 744-748.

Research output: Contribution to journalArticle

Escobar, Guillermo A. ; Eliason, Jonathan L. ; Hurie, Justin ; Arya, Shipra ; Rectenwald, John E. ; Coleman, Dawn M. / Rifampin soaking Dacron-based endografts for implantation in infected aortic aneurysms - New application of a time-tested principle. In: Annals of Vascular Surgery. 2014 ; Vol. 28, No. 3. pp. 744-748.
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