Graft infection after endovascular abdominal aortic aneurysm repair

摘要: Introduction Although the natural history and management of infected open abdominal aortic aneurysm (AAA) repair is well described, only sporadic case reports have described fate patients with endografts placed in aorta. The present study describes a tertiary referral center's experience endovascular repairs (EVARs). Methods medical records 1302 procedures were queried from January 2000 to 2010. cases reviewed for prior procedures, prosthetic implants, etiology current procedure. Demographics, operative details, perioperative courses documented. Results Nine (1 woman) mean age 71 years had an EVAR that later required procedure explantation surgical revision suspected infection. All grafts explanted through midline transperitoneal approach, time explant 33 months. included 4 Zenith (Cook, Bloomington, Ind), 2 Ancure (Endovascular Technologies, Menlo Park, Calif), Excluders (Gore, Flagstaff, Ariz), 1 AneuRx (Medtronic, Minneapolis, Minn). Eight nine original EVARs performed at other hospitals; patient University Michigan. preoperative computed tomography scans, except one who was transferred extremis gastrointestinal hemorrhage. Three also tagged leukocyte scan, two magnetic resonance imaging further reinforce suspicion infection before bypass planning. Rifampin-soaked Hemashield (Boston Scientific) situ used four patients, extra-anatomic (axillary-bifemoral) five. group no positive or postoperative cultures, exception unstable died day surgery. For five tissue cultures found Bacteroides, Escherichia coli, coagulase-negative Staphylococcus, Streptococcus, Candida. aortic-enteric fistula, whom discharge hospital. remaining seven survived discharge. Average length stay 22 days, median follow-up 11 Conclusion This series largest AAA reported date. Because AAAs presently most common method repair, development endograft infection, while rare, can be managed acceptable mortality rates. Patients presenting fistula after appear more virulent course.