|
51
|
Molacek J, Treska V, Houdek K, Opatrný V, Certik B, Baxa J. Use of a Silver-Impregnated Vascular Graft: Single-Center Experience. Antibiotics (Basel) 2022; 11:386. [PMID: 35326849 PMCID: PMC8944627 DOI: 10.3390/antibiotics11030386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/27/2022] [Accepted: 03/04/2022] [Indexed: 12/10/2022] Open
Abstract
INTRODUCTION Vascular graft infection is a life threatening situation with significant morbidity and mortality. Bacterial graft infection can lead to false aneurysms, bleeding and sepsis. There are a lot of risky situations where grafts can become infected. It is therefore highly desirable to have a vascular graft that is resistant to infection. In this retrospective clinical study, a silver-impregnated vascular graft was evaluated in various indications. METHODS Our study included a total of 71 patients who received a silver-impregnated vascular graft during the period from 2013 to 2018. Patients had an aortoiliac localization of vascular graft in 61 cases (86%), and a peripheral localization on the lower limbs in 10 cases (14%). Indications for the use of these special vascular grafts were trophic lesions or gangrene in the lower limbs in 24 cases (34%), suspicious mycotic abdominal aortic aneurysm (mAAA) in 4 cases (5.5%), salmonela aortitis or aneurysms in 4 cases (5.5%), infection of the previous vascular graft in 11 cases (15.5%), other infections in 12 cases (17%), AAA rupture in 10 cases (14%) and other reasons (pre-transplant condition, multiple trauma, graft-enteric fistula) in 6 cases (8.5%). Thirty-day mortality, morbidity, the need for reintervention and amputation, primary and secondary graft patency, and finally the presence of a proven vascular graft infection were evaluated. RESULTS The 30-day mortality was 19.7%, and morbidity was 42.2%. The primary patency of the vascular graft was 91.5%. Reoperation was necessary in 10 cases (14%) and amputation was necessary in 10 cases (14%). The median length of hospital stay was 13 days and the mean follow-up period was 48 ± 9 months. During the follow-up period, six patients (8.5%) died from reasons unrelated to surgery or without any relation to the vascular graft. Secondary patency after one year was 88%. Infection of the silver graft was observed in three patients (4.2%). CONCLUSIONS Based on our results, the silver graft is a very suitable alternative for solving infectious, or potentially infectious, situations in vascular surgery. In particular, in urgent or acute cases, a silver graft is often the only option.
Collapse
Affiliation(s)
- Jiri Molacek
- Vascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech Republic; (V.T.); (K.H.); (V.O.); (B.C.)
| | - Vladislav Treska
- Vascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech Republic; (V.T.); (K.H.); (V.O.); (B.C.)
| | - Karel Houdek
- Vascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech Republic; (V.T.); (K.H.); (V.O.); (B.C.)
| | - Václav Opatrný
- Vascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech Republic; (V.T.); (K.H.); (V.O.); (B.C.)
| | - Bohuslav Certik
- Vascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech Republic; (V.T.); (K.H.); (V.O.); (B.C.)
| | - Jan Baxa
- Department of Imagine Methods, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech Republic;
| |
Collapse
|
|
52
|
Brandau A, Ibrahim N, Klopf J, Hayden H, Ozsvar-Kozma M, Afonyushkin T, Bleichert S, Fuchs L, Watzinger V, Nairz V, Manville E, Kessler V, Stangl H, Eilenberg W, Neumayer C, Brostjan C. Association of Lipoproteins with Neutrophil Extracellular Traps in Patients with Abdominal Aortic Aneurysm. Biomedicines 2022; 10:biomedicines10020217. [PMID: 35203427 PMCID: PMC8869298 DOI: 10.3390/biomedicines10020217] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 02/01/2023] Open
Abstract
Neutrophil extracellular traps (NETs) are DNA–protein structures released by neutrophils in response to various stimuli, including oxidized, low-density lipoprotein (oxLDL). Accumulating evidence suggests a role for NETs in the pathogenesis of abdominal aortic aneurysm (AAA). In this study, we investigated the potential association of lipoprotein particles and NETs in AAA in comparison to non-AAA control groups. The concentrations of neutrophil myeloperoxidase (MPO), the NET parameters citrullinated histone H3 (citH3) and circulating cell-free DNA (cfDNA), as well as of blood lipids were determined in plasma or serum of patients with AAA (n = 40), peripheral artery occlusive disease (PAD; n = 40) and healthy donors (n = 29). A sandwich ELISA detecting oxidized phosphatidylcholine in association with apolipoprotein B-100 (oxPL/apoB) was applied to measure oxidized phospholipids in circulation. The effect of lipoparticles on NET formation was tested using a DNA release assay with isolated human neutrophils. Plasma MPO, citH3 and cfDNA levels were significantly increased in AAA patients in comparison to healthy donors and PAD patients. Plasma concentrations of citH3 positively correlated with serum oxPL/apoB in AAA patients. In functional in vitro assays, the addition of oxLDL induced NET formation in pre-stimulated neutrophils. In conclusion, our data suggest a promoting role of oxLDL on NET formation in AAA patients.
Collapse
Affiliation(s)
- Annika Brandau
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Nahla Ibrahim
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Johannes Klopf
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Hubert Hayden
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Maria Ozsvar-Kozma
- Department of Laboratory Medicine, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (M.O.-K.); (T.A.)
| | - Taras Afonyushkin
- Department of Laboratory Medicine, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (M.O.-K.); (T.A.)
| | - Sonja Bleichert
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Lukas Fuchs
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Viktoria Watzinger
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Verena Nairz
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Emely Manville
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Veronika Kessler
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Herbert Stangl
- Center for Pathobiochemistry and Genetics, Department of Medical Chemistry, Medical University of Vienna, 1090 Vienna, Austria;
| | - Wolf Eilenberg
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Christoph Neumayer
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
| | - Christine Brostjan
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria; (A.B.); (N.I.); (J.K.); (H.H.); (S.B.); (L.F.); (V.W.); (V.N.); (E.M.); (V.K.); (W.E.); (C.N.)
- Correspondence: ; Tel.: +43-1-40400-73514
| |
Collapse
|