Antibiotics and Percutaneous Drainage for Treating Stent-Graft Infection After EVAR

Zhu, Feng; Ge, Xiaohu; Ci, Hongbo; Guan, Sheng

doi:10.1016/j.avsg.2019.12.009

Cited by 5 publications

(6 citation statements)

References 18 publications

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“…The drain can be left in situ until there is minimal output and the patient improves clinically 23. Given the high risk of recurrent endograft infection, the patient is generally put on lifelong suppressive antibiotics 23. The feasibility of percutaneous drain placement for the management of infected endograft is corroborated by previous literature on conservative treatment of graft infection after open aortic surgery 24…”

Section: Discussionmentioning

confidence: 96%

“…The optimal method for source control is open surgery with endograft explantation, washout and debridement of infected tissue, and aortic reconstruction with native tissue 22. However, patients with prohibitive surgical risk due to factors such as age, comorbidities or frailty may benefit from placement of a percutaneous drain 23. The drain can be left in situ until there is minimal output and the patient improves clinically 23.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients with prohibitive surgical risk due to factors such as age, comorbidities or frailty may benefit from placement of a percutaneous drain 23. The drain can be left in situ until there is minimal output and the patient improves clinically 23. Given the high risk of recurrent endograft infection, the patient is generally put on lifelong suppressive antibiotics 23.…”

Section: Discussionmentioning

confidence: 99%

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Presentation and management of delayed aortic endograft infection

Hennessey²,

Fenton³

et al. 2023

BMJ Case Rep

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A man in his 60s who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm 4 years ago presents with 1 week of abdominal pain, fever and leucocytosis. CT angiogram demonstrated an enlarged aneurysm sac with intraluminal gas and periaortic stranding consistent with infected EVAR. He was clinically unfit for an open surgical intervention due to his significant cardiac comorbidities, including hypertension, dyslipidaemia, type 2 diabetes, recent coronary artery bypass grafting and congestive heart failure secondary to ischaemic cardiomyopathy with an ejection fraction of 30%. Therefore, due to this significant surgical risk, he was treated with percutaneous drainage for the aortic collection and lifelong antibiotics. The patient is well 8 months following presentation with no signs of ongoing endograft infection, residual aneurysm sac enlargement, endoleak or haemodynamic instability.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Presentation and management of delayed aortic endograft infection

Hennessey²,

Fenton³

et al. 2023

BMJ Case Rep

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“…Emergency endografting was effective in preventing exsanguination at the time of aortic rupture but resulted in B suis infection of the prosthetic graft. While preservation of infected endoprotheses may sometimes be effective 14,15 using various combinations of antibiotics and drainage, it is usually necessary to completely remove the infected endograft followed by vascular reconstruction. [16][17][18][19] In this case, the aorta was reconstructed using a technique popularized by Clagett 20 in the U.S. and Nevelsteen 21,22 in Belgium utilizing femoral veins as arterial substitutes.…”

Section: Discussionmentioning

confidence: 99%

The Role of Feral Swine in Human Aortic Infection With Brucella Species

Team

Parrott

Gucwa

et al. 2023

Vasc Endovascular Surg

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Brucellosis is one of the most common zoonotic infections in the world. Human infections are the result of direct exposure to infected animals or ingestion of unprocessed dairy products. While Brucella sp. infection has largely been eliminated from commercial cattle and swine with aggressive vaccination, there is a significant prevalence of Brucella sp. infection in the expanding population of feral swine in the US. We report the surgical treatment of a ruptured mycotic aneurysm of the abdominal aorta due to Brucella suis in a woman living in a rural community with a large population of feral swine. Vascular surgeons should be aware that brucellosis can result in arterial infection and should be considered in the differential diagnosis in patients with a history of exposure to feral swine or the ingestion of unprocessed dairy products.

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“…Endograft infections may be managed conservatively with antibiotics and possible percutaneous drainage; severe cases could require endograft removal [ 52 , 53 , 55 , 56 ].…”

Section: Endograft Device-related Complicationsmentioning

confidence: 99%

CT angiography for the assessment of EVAR complications: a pictorial review

Gozzo¹,

Caruana

Cannella

et al. 2022

Insights Imaging

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Endovascular aneurysm repair (EVAR) is a minimally invasive treatment proposed as an alternative to open repair in patients with abdominal aortic aneurysms. EVAR consists in a stent-graft placement within the aorta in order to exclude the aneurysm from arterial circulation and reduce the risk of rupture. Knowledge of the various types of devices is mandatory because some stents/grafts are more frequently associated with complications. CT angiography is the gold standard diagnostic technique for preprocedural planning and postprocedural surveillance. EVAR needs long-term follow-up due to the high rate of complications. Complications can be divided in endograft device-related and systemic complications. The purpose of this article is to review the CT imaging findings of EVAR complications and the key features for the diagnosis.

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Antibiotics and Percutaneous Drainage for Treating Stent-Graft Infection After EVAR

Cited by 5 publications

References 18 publications

Presentation and management of delayed aortic endograft infection

Presentation and management of delayed aortic endograft infection

The Role of Feral Swine in Human Aortic Infection With Brucella Species

CT angiography for the assessment of EVAR complications: a pictorial review

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