Addressing Endograft Infection After EVAR.
Description
C. Schürmann and H. Alkassam contributed equally to this work.
Publisher DOI
PubMed ID
41231187
Abstract
Background
Although rare, endograft infection is a severe complication of endovascular aneurysm repair (EVAR), usually requiring open endograft explantation and aortic reconstruction. This single-center retrospective series analyzed 9 consecutive patients who underwent EVAR explantation for infection from 2004 to 2023.
Case Summary
EVAR infection was diagnosed a median of 10 months (IQR: 3.25-21.5 months) after EVAR implantation. Eight patients underwent in situ reconstruction with physician-made bovine pericardial grafts, and in 1 patient, a silver-impregnated prosthetic graft was used. Two patients died within 30 days. One aortic reintervention was necessary owing to bleeding. Median follow-up was 10.5 months (IQR: 5-54 months). Two patients died during follow-up, but there were no aortic-related complications except for 1 reinfection in the patient who had been treated with a silver-impregnated prosthetic graft.
Conclusions
Despite the relevant perioperative morbidity and mortality associated with EVAR infection, endograft explantation and in situ reconstruction with preferably bovine pericardial grafts may offer definitive treatment of infection, with promising mid- and long-term results.
Although rare, endograft infection is a severe complication of endovascular aneurysm repair (EVAR), usually requiring open endograft explantation and aortic reconstruction. This single-center retrospective series analyzed 9 consecutive patients who underwent EVAR explantation for infection from 2004 to 2023.
Case Summary
EVAR infection was diagnosed a median of 10 months (IQR: 3.25-21.5 months) after EVAR implantation. Eight patients underwent in situ reconstruction with physician-made bovine pericardial grafts, and in 1 patient, a silver-impregnated prosthetic graft was used. Two patients died within 30 days. One aortic reintervention was necessary owing to bleeding. Median follow-up was 10.5 months (IQR: 5-54 months). Two patients died during follow-up, but there were no aortic-related complications except for 1 reinfection in the patient who had been treated with a silver-impregnated prosthetic graft.
Conclusions
Despite the relevant perioperative morbidity and mortality associated with EVAR infection, endograft explantation and in situ reconstruction with preferably bovine pericardial grafts may offer definitive treatment of infection, with promising mid- and long-term results.
Date Issued
2026-01-07
Publication Type
Article
Subject(s)
Subjects
)
•
EVAR explantation
•
abdominal aortic aneurysm (AAA)
•
endograft infection
•
endovascular aneurysm repair (EVAR
•
physician-made bovine pericardial grafts
Language(s)
en
Author(s)
Additional Credits
Journal
JACC: Case Reports
Publisher
Elsevier
ISSN
2666-0849
Access(Rights)
open.access