title: [Management of endo-graft infection following endovascular repair of abdominal aortic aneurysm].
abstract: OBJECTIVE
  To summarize our experience in the management of stent-graft infection after endo-vascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA).
  
  
  METHODS
  Data of patients who were diagnosed as endo-graft infection following EVAR and admitted in our center between January 2000 and December 2015 were reviewed. Clinical records including causes of infection, medical history, re-operative procedures, and prognostic data were analysed.
  
  
  RESULTS
  A total of 10 male patients, aged 45-72 years (averaged 62.5 years), were enrolled. Two patients received previous EVAR in our center, accounting for 0.23% of all the 885 EVAR procedures we conducted during the same period. The symptoms related to stent infection, including recurrent fever (100%) and persistent back pain (40%), occured 0 to 27 months (averaged 6.9 months) after EVAR procedure. Eight patients were found to have apparent causes (80%), including 1 case with upper respiratory infection and sepsis, 4 cases with aorto-enteric fistula (AEF) and 3 cases with inflammatory AAA. Except one DNR, other 9 patients received re-operation, including 1 procedure of open debridement and drainage, 1 procedure of endo-graft excision and bilateral axillary-femoral bypass, 7 procedures of endograft excision and axillary-bifemoral bypass. During the follow-up period(2-60 months, averaged 24.1 months), 1 patient was lost, 1 patient died from aortic stump rupture (12.5%) and other 7 patients survived. Bypass occlusion was observed in 1 patient (12.5%) without severe limb ischemia.
  
  
  CONCLUSIONS
  AEF and inflammatory AAA are two leading causes of endo-graft infection following EVAR in our patients. Graft excision and axillofemoral bypass is an acceptable management for this life-threatening morbidity.
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: H H
authors.initials: HH
authors.lastname: Yin
authors.forename: M
authors.initials: M
authors.lastname: Wang
authors.forename: Z L
authors.initials: ZL
authors.lastname: Li
authors.forename: C
authors.initials: C
authors.lastname: Yao
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Hu
authors.forename: J S
authors.initials: JS
authors.lastname: Wang
authors.forename: G Q
authors.initials: GQ
authors.lastname: Chang
authors.forename: S M
authors.initials: SM
authors.lastname: Wang
mesh_terms: D000368:Aged; D001011:Aorta; D017544:Aortic Aneurysm, Abdominal; D001019:Aortic Rupture; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007239:Infections; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D015607:Stents