title: Late Conversion After Sac Anchoring Endoprosthesis for Secondary Aortic Aneurysm Infection.
abstract: OBJECTIVE
  To demonstrate explantation of the Nellix Endovascular Aneurysm Sealing (EVAS) System in the setting of infection.
  
  
  METHODS
  Two male patients, 71 and 83 years old, underwent Nellix implantation for asymptomatic infrarenal aortic aneurysms measuring 5.1 and 6.3 cm, respectively. Each developed late infections at 8 and 4 months post EVAS, respectively. The first patient experienced aneurysm rupture after medical therapy failed; the Nellix endosystem was explanted in an uneventful procedure. The second patient developed an aortoduodenal fistula, which was sutured before the Nellix device was removed without complications. The patient died 3 months later, presumably due to ongoing infection.
  
  
  CONCLUSIONS
  The need to explant a Nellix EVAS System due to graft infection is a straightforward procedure compared to the removal of a conventional endograft with suprarenal fixation. It requires only temporary suprarenal clamping. The devices can be easily removed due to the lack of penetrating components and without damage to the aortic segment needed to create an anastomosis.
authors: Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors: Jip L
authors: JL
authors: Tolenaar
authors: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors: Leo H
authors: LH
authors: van den Ham
authors: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors: Michel M P J
authors: MM
authors: Reijnen
authors: Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands j.vries@antoniusziekenhuis.nl.
authors: Jean-Paul P M
authors: JP
authors: de Vries
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D003250:Constriction; D020878:Device Removal; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D013536:Suture Techniques; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: abdominal aortic aneurysm; aneurysm rupture; aortoduodenal fistula; endovascular aneurysm sealing; explantation; graft infection; sac-anchoring device