Diagnosis and treatment of graft infection following endovascular aortic aneurysm repair
NING Jun-jie
CHANG Guang-qi
Abstract：Aortic endograft infection(AEI)is a rare but potentially fatal complication after endovascular aneurysm repair(EVAR).There is currently no large-scale prospective clinical study to determine the optimal treatment for AEI.Infection at any site may be the causative pathogen for AEI.The clinical manifestations of AEI range from asymptomatic,fatigue,fever,pain,weight loss,and gastrointestinal bleeding,to the most severe shock.The diagnosis of AEI requires a combination of multifaceted evidence,including clinical manifestations,imaging examinations,and laboratory test results.The most common diagnosis criteria are proposed by the Management of Aortic Graft Infection Collaboration(MAGIC).The preferred treatment for AEI is complete removal of the infected graft,followed by in situ aortic reconstruction or extra-anatomical bypass surgery,depending on the specific circumstances.For patients with a short life expectancy and high surgical risks,partial graft resection or conservative treatment(long-term anti-infection treatment with selected antibiotics based on culture results and drug sensitivity test results,supplemented by percutaneous drainage and antimicrobial solution irrigation of localized abscesses)can be considered.To effectively prevent AEI,appropriate patients for EVAR should be strictly selected,the principle of sterility should be followed during the procedure,and the re-intervention rate should be reduced.
Keywords：endovascular aneurysm repair(EVAR)aortic endograftgraft infectionimaging examinationantibiotic therapysurgical treatmentvascular surgerytreatment strategy
Publication Date：2024-12-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1366-1371 )