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The management of aortic stent-graft infection: endograft removal versus conservative treatment. | LitMetric

AI Article Synopsis

  • Aortic stent-graft infections (ASGIs) are serious and can lead to high mortality rates; this study discusses two successful treatment cases with different approaches.
  • Patient 1 received conservative treatment due to high surgical risk, while Patient 2 had endograft removal to address their infection; both patients showed no recurrent infection after 6 months.
  • The study highlights that conservative treatment can be effective for high-risk patients, and it notes the first case of ASGI from Streptococcus haemolyticus and a fungal infection, along with a rare case of spondylodiscitis post-EVAR.

Article Abstract

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.

Conclusion: 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.

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Source
http://dx.doi.org/10.1016/j.avsg.2009.11.003DOI Listing

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