title: Endovascular management of infected iliofemoral pseudoaneurysms - a systematic review.
abstract: We conducted a systematic review regarding the efficacy and outcome of endovascular treatment of infected iliofemoral arterial pseudoaneurysms with covered stents. 35 cases were identified, including 5 own. 22 pseudoaneurysms were located in the femoral area and 13 in the iliac vessels. The most commonly reported complaints were pulsatile groin mass (40 %), sepsis (37.1 %), active bleeding (31.4 %), and groin infection with purulent discharge (17.1 %). S. aureus (65.7 %) and Streptococcus species (22.9 %) were the most common microbes isolated. Factors for the development of infected pseudoaneurysms were intravenous drug use (20 %), infection of anastomosis in bypass surgery (22.9 %), cancer (14.3 %), history of multiple hip operations (14.3 %), renal transplantation (2.9 %), and obesity (5.7 %). The most commonly used covered stents were Viabahn (22.9 %),Jostent (17.1 %), Fluency (14.3 %), and Wallgraft (14.3 %). In 15 cases, surgical debridement and/or drainage was also performed.The mean follow-up was 15.8 months. There were only 2 cases of stent graft thrombosis (5.7 %). 2 patients required an open vascular bypass procedure at a later stage. One death was attributed to procedure-related complications (2.9 %). The infection rate of the deployed stent graft in follow-up was 3.4 %. Endovascular exclusion of an infected pseudoaneurysm with primary stent grafting and drainage may be an option in high-risk patients. .
authors.affiliation: 1 Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: Konstantinos G
authors.initials: KG
authors.lastname: Moulakakis
authors.affiliation: 1 Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.|3 Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.
authors.forename: Vangelis G
authors.initials: VG
authors.lastname: Alexiou
authors.affiliation: 1 Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: George S
authors.initials: GS
authors.lastname: Sfyroeras
authors.affiliation: 1 Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kakisis
authors.affiliation: 1 Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lazaris
authors.affiliation: 1 Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: Spyridon N
authors.initials: SN
authors.lastname: Vasdekis
authors.affiliation: 2 Department of Radiology, Athens University Medical School, Attikon, University Hospital, Athens, Greece.
authors.forename: Elias N
authors.initials: EN
authors.lastname: Brountzos
authors.affiliation: 1 Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Geroulakos
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D003646:Debridement; D004322:Drainage; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005263:Femoral Artery / Q000382:microbiology / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000209:etiology; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: Femoral artery; covered stent; endovascular; iliac; infected aneurysm; pseudoaneurysm