Endovascular grafting of traumatic aortic aneurysms in contaminated fields.
OBJECTIVE
To evaluate the potential of endovascular stent-grafts to treat traumatic aortic lesions in contaminated areas.


METHODS
Four patients (3 women; ages 26-78 years) underwent stent-grafting to repair an aortic rupture sustained in a motorcycle accident, aortic lacerations secondary to surgical treatment of spondylitis in 2 patients, and an aortobronchial fistula following surgical thoracic aortic repair 10 years earlier. Stent-grafts (2 Corvita, 1 Talent, and 1 Vanguard) were placed endoluminally into the infected areas via a transfemoral approach. Follow-up included erythrocyte sedimentation rate, white blood count, C-reactive protein, blood cultures, and computed tomography (CT).


RESULTS
The stent-grafts were successfully placed in all cases and excluded the aortic lesion. Under supportive antibiotic therapy, inflammation parameters returned to normal. CT imaging showed no evidence of paraprosthetic infection, nor were there any other complications over a follow-up that ranged from 3 to 34 months.


CONCLUSIONS
Endovascular therapy may be an alternative in the acute management of aortic ruptures in the setting of infection. Long-term results are required for definitive evaluation of the method.
Krämer
S
S
Department of Radiology, University of Ulm, Germany. stefan.kraemer@medizin.uni-ulm.de
Pamler
R
R
Seifarth
H
H
Brambs
H J
HJ
Sunder-Plassmann
L
L
Görich
J
J
D000328:Adult; D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000601:surgery*; D001019:Aortic Rupture / Q000150:complications* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D013530:Surgical Wound Infection / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures