Stent-graft treatment of infected aortic and arterial aneurysms.
OBJECTIVE
To evaluate the feasibility and effectiveness of endovascular stent-graft repair of infected aortic and arterial aneurysms.


METHODS
Eight patients (5 men; mean age 56.6 years, range 30-85) with infected saccular aneurysms in the brachiocephalic artery (n=1), proximal descending thoracic aorta (n=1), infrarenal abdominal aorta (n=3), common iliac artery (n=1), and common femoral artery (n=2) were treated with stent-graft placement and intravenous antibiotic treatment for at least 6 weeks followed by case-specific administration of oral suppressive antibiotics. All patients were considered to be in the high-surgical-risk group.


RESULTS
Exclusion of the infected aneurysm was successful in all patients. However, 2 patients died within 30 days of uncontrolled sepsis, and 1 patient died at 6 months after rupture of a persistently infected aneurysm (37% mortality rate). Over a follow-up that ranged to 8 years, the 5 survivors showed complete resolution of the infected aneurysms; no stent-graft infection was observed during follow-up.


CONCLUSIONS
The acceptable technical and clinical success of endovascular aneurysm repair makes this a promising treatment for infected aortic and arterial aneurysms. However, it is crucial that the infection is treated adequately prior to stent-graft placement.
Lee
Kwang-Hun
KH
Department of Radiology and Research Institute of Radiological Science, Seoul, Republic of Korea.
Won
Jong Yun
JY
Lee
Do Yun
DY
Choi
Donghoon
D
Shim
Won-Heum
WH
Chang
Byung Chul
BC
Park
Sang Joon
SJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017130:Angioplasty; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D017544:Aortic Aneurysm, Abdominal / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017543:Iliac Aneurysm / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents