The Management of Aortic Stent-Graft Infection: Endograft Removal Versus Conservative Treatment

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.