title: Selection of surgical methods for infected infrarenal abdominal aortic aneurysms.
abstract: BACKGROUND
  There is no standard treatment for patients with infected abdominal aortic aneurysm (AAA). To determine the basis for selection of a surgical method, we reviewed our experiences with all patients who underwent surgery for infected infrarenal AAA.
  
  
  METHODS
  Between 1993 and 2000, 6 patients with infected infrarenal AAA underwent surgery. Extra-anatomic bypass grafting was performed in 2 of 3 patients with infection extending into the retroperitoneum. In situ grafting was performed in 3 patients with localized infection and in 1 patient with extended infection.
  
  
  RESULTS
  Severe peritonitis occurred in 2 patients with extended infection in the early postoperative phase. One patient, who had undergone in situ grafting, died of sepsis. The other patient, who had undergone extra-anatomic bypass grafting, was treated by continuous irrigation with an electrolyzed strong acid aqueous solution (ESAAS). He recovered gradually and was discharged. After a follow-up period with a mean of 40 months (range: 17-102 months), all 5 patients who survived surgery are alive and asymptomatic.
  
  
  CONCLUSIONS
  It was suggested that the method used for revascularization should be selected based on the degree of diffusion of infection. For a patient with extended infection, postoperative continuous irrigation with ESAAS appears to be effective in eradicating retroperitoneal infection.
authors.affiliation: Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Iwate Medical University, Morioka, Japan. t_nakajima@imu.ncvc.go.jp
authors.forename: T
authors.initials: T
authors.lastname: Nakajima
authors.forename: K
authors.initials: K
authors.lastname: Kawazoe
authors.forename: H
authors.initials: H
authors.lastname: Izumoto
authors.forename: T
authors.initials: T
authors.lastname: Kawase
authors.forename: M
authors.initials: M
authors.lastname: Mukaida
authors.forename: T
authors.initials: T
authors.lastname: Kataoka
authors.forename: T
authors.initials: T
authors.lastname: Oka
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003646:Debridement; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D007507:Therapeutic Irrigation