The management of aortic stent-graft infection: endograft removal versus conservative treatment.
BACKGROUND
Aortic stent-graft infections (ASGIs) are associated with significant mortality. We report our experience of two cases of ASGI treated differently and successfully.


METHODS
Two patients presented with constitutional symptoms some months after scheduled endovascular repair of aortic aneurysm (EVAR). Patient 1 had an abscess formation around the endograft in continuity with the right groin. Due to patient comorbidities, a conservative treatment was performed. Patient 2 had an abscess formation with air surrounding the stent graft. The patient was treated successfully by endograft removal.


RESULTS
Computed tomographic scan follow-up at 6 months from surgery showed no evidence of recurrent infection.


CONCLUSIONS
Despite the recommended treatment of ASGI being surgery, conservative treatment can be performed successfully in patients with high surgical risk, avoiding aortic clamping. We present the first reported case of ASGI due to Streptococcus haemolyticus, the second case due to a fungus, and the second reported case of spondylodiscitis after EVAR.
Blanch
Montse
M
Department of Angiology and Vascular Surgery, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain. montse.blanch@hotmail.com
Berjón
Jennifer
J
Vila
Ramon
R
Simeon
Josep Maria
JM
Romera
Antonio
A
Riera
Santiago
S
Cairols
Marc Antoni
MA
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001014:Aortic Aneurysm / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D002176:Candida albicans / Q000302:isolation & purification; D003646:Debridement; D020878:Device Removal; D015299:Discitis / Q000209:etiology; D016972:Enterobacter cloacae / Q000302:isolation & purification; D006801:Humans; D008297:Male; D011424:Propionibacterium / Q000302:isolation & purification; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D015607:Stents / Q000009:adverse effects*; D013291:Streptococcus / Q000302:isolation & purification; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents