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Background: Surgical site infections (SSI) are frequently seen after aortoiliac vascular surgery (2%-14%). Deep SSIs are associated with graft infection, sepsis, and mortality. This study evaluates the difference in incidence and nature of SSI following open aortoiliac surgery for aneurysmal disease compared to occlusive arterial disease. Methods: A retrospective cohort study was conducted, including all consecutive patients who underwent open aortoiliac vascular surgery between January 2005 and December 2016 in the Amphia Hospital, Breda, the Netherlands. Patients were grouped by disease type, either aneurysmal or occlusive arterial disease. Data were gathered, including patient characteristics, potential risk factors, and development of SSI. Surgical site infections were defined in accordance with the criteria of the Centers for Disease Control. Results: Between January 2005 and December 2016, a total of 756 patients underwent open aortoiliac surgery of which 517 had aortoiliac aneurysms and 225 had aortoiliac occlusive disease. The group with occlusive disease was younger, predominantly male, and had more smokers. After exclusion of 228 patients undergoing acute surgery, the SSI rate after elective surgery was 6.2%, with 10 of 301 SSIs in the aneurysmal group (3.0%) and 22 of 213 SSIs in the group with occlusive disease (10.3%, P <.001). Also, infection-related readmission and reintervention were higher after occlusive surgery, 6.6% versus 0.9% (P <.001) and 4.2% versus 0.9% (P =.003), respectively. Staphylococcus aureus was found as the most common pathogen, causing 64% of SSI in occlusive disease versus 10% in aneurysmal disease (P =.005). Logistic regression showed occlusive arterial disease and chronic renal disease were associated with SSI. Conclusion: Our study presents evidence for a higher rate of SSI in patients with aortoiliac occlusive disease compared to aortoiliac aneurysmal disease, in part due to inherent use of inguinal incision in patients with occlusive disease. All precautions to prevent SSI should be taken in patients undergoing vascular surgery for arterial occlusive disease. [ABSTRACT FROM AUTHOR]

This study was conducted to validate a proposed classification system on the characteristics of the abdominal aortic aneurysm neck. The cohort comprised 100 consecutive patients who underwent open or endovascular aneurysm repair. Aneurysm neck characteristics of diameter, calcium, thrombus, and angulation were reviewed. The presence of calcium at the aortic aneurysm wall was associated with lower body mass index. Thrombus was found in 52% of the patients. Hypertension was correlated with the presence of aortic wall thrombus. At the renal artery level, angulation was anterior in 56%, right lateral in 39%, and left lateral in 27%. At the origin of the aneurysm, angulation was posterior in 76%, right lateral in 46%, and left lateral in 42%. A wide variety in these characteristics was found. A scoring system allows comparison of patient characteristics in studies describing the clinical outcome of endovascular aneurysm repair and should be included in study reports. [ABSTRACT FROM AUTHOR]