Comparison of Outcomes After Open Surgical and Endovascular Lower Extremity Revascularisation Among End Stage Renal Disease Patients on Dialysis

Abstract

patients had positive cultures; the most prevalent agent was Staphylococcus aureus (n = 16; 31%). Operative techniques included thoracic endovascular aortic repair (TEVAR; n = 35 [67%]), fenestrated/branched TEVAR (n = 8; 15%), hybrid repair (n = 7; 14%), and open patch repair (n = 2; 4%). Survival was 92% (95% confidence interval [CI] 88e96) at 30 days, 88% (95% CI 84e93) at three months, 78% (73e84) at one year, and 71% (64e77) at five years. The mean follow up among survivors (> 90 days) was 45 months (range 4e216 months). Antibiotics were administered for amedian of 15 weeks (range 0e220weeks). IRCs occurred in nine patients (17%): sepsis (n = 3), graft infection (n = 3), recurrentmycotic aneurysm (n = 1), aorto-oesophageal/bronchial fistula (n = 2). Six (67%) IRCs were fatal; 80% occurred within the first year. Re-operations were performed in nine patients (17%). Conclusions: TEVAR was often used as treatment for MTAAs, with acceptable shortand long-term survival when compared with open cohorts in the literature. IRCs are of concern and warrant follow up and long-term antibiotic treatment.