Diagnosis and Management of Aortic Stent Graft Infection (Report of 4 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FANG Zhengdong , FU Weiguo , WANG Yuqi , GUO Daqiao , XU Xin , CHEN Bin

Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China;

Corresponding author：

Keywords：

Complications; Infection; Arteriae aorta; Stent graft

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Objective To study the diagnostic procedures and management of aortic stent graft infection. Methods Clinical data of 4 patients with aortic stent graft infection from 1998 to 2008 were analyzed retrospectively. Results Primary disease was thoracic endovascular aortic repair in 2 cases and endovascular aneurysm repair in another 2 cases. Constitutional symptoms and abscess information on imaging studies were presented in all patients. Salmonella choleraesuis was revealed in 2 cases. Surgical debridement, drainage and systematic antimicrobial therapies were given to 2 patients. The remaining 2 patients were managed with antimicrobial therapy only. During follow-up, there was no recurrence of infection. Conclusions Infection of aortic stent graft infection is a rare but potentially devastating complication. Radiologic studies can serve as important adjuncts in the diagnosis of endovascular graft infections. Several treatment options are available, some cases may be managed with conservative treatment.

Citation： FANG Zhengdong,FU Weiguo,WANG Yuqi,GUO Daqiao,XU Xin,CHEN Bin. Diagnosis and Management of Aortic Stent Graft Infection (Report of 4 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(6): 429-432. doi: Copy

1.	Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms [Ｊ]. Ann Vasc Surg, 1991; 5(6): 491-499.
2.	景在平, 冯翔. 主动脉疾病腔内治疗的进展与前景 [Ｊ]. 中国普外基础与临床杂志, 2003; 10(3): 215-217.
3.	郭伟, 杨代华. 腹主动脉瘤腔内修复术后内漏的诊断与治疗 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(6): 636-637.
4.	Chalmers N, Eadington DW, Gandanhamo D, et al. Case report: infected false aneurysm at the site of an iliac stent [Ｊ]. Br J Radiol, 1993; 66(790): 946-948.
5.	施德兵, 符伟国, 王玉琦, 等. 合并马凡综合征的破裂腹主动脉瘤腔内治疗术后并发感染 [Ｊ]. 中国实用外科杂志, 2006; 26(5): 391-394.
6.	Fu WG, Shi DB, Wang YQ, et al. Aortic stent graft infection in a patient with Marfan syndrome [Ｊ]. Chin Med J (Engl), 2007; 120(10): 935-937.
7.	Silberfein EJ, Lin PH, Bush RL, et al. Aortic endograft infection due to Pasteurella multocida following a rabbit bite [Ｊ]. J Vasc Surg, 2006; 43(2): 393-395.
8.	Ducasse E, Calisti A, Speziale F, et al. Aortoiliac stent graft infection: current problems and management [Ｊ]. Ann Vasc Surg, 2004; 18(5): 521-526.
9.	Fiorani P, Speziale F, Calisti A, et al. Endovascular graft infection: preliminary results of an international enquiry [Ｊ]. J Endovasc Ther, 2003; 10(5): 919-927.
10.	Heyer KS, Modi P, Morasch MD, et al. Secondary infections of thoracic and abdominal aortic endografts [Ｊ]. J Vasc Interv Radiol, 2009; 20(2): 173-179.
11.	Zetrenne E, McIntosh BC, McRae MH, et al. Prosthetic va-scular graft infection: a multi-center review of surgical management [Ｊ]. Yale J Biol Med, 2007; 80(3): 113-121.
12.	Sharif MA, Lee B, Lau LL, et al. Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair [Ｊ]. J Vasc Surg, 2007; 46(3): 442-448.
13.	Parsons RE, Sanchez LA, Marin ML, et al. Comparison of endovascular and conventional vascular prostheses in an experimental infection model [Ｊ]. J Vasc Surg, 1996; 24(6): 920-925; discussion 925-926.
14.	Speziale F, Calisti A, Zaccagnini D, et al. The value of technetium-99m HMPAO leukocyte scintigraphy in infectious abdominal aortic aneurysm stent graft complications [Ｊ]. J Vasc Surg, 2002; 35(6): 1306-1307.

1. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms [Ｊ]. Ann Vasc Surg, 1991; 5(6): 491-499.
2. 景在平, 冯翔. 主动脉疾病腔内治疗的进展与前景 [Ｊ]. 中国普外基础与临床杂志, 2003; 10(3): 215-217.
3. 郭伟, 杨代华. 腹主动脉瘤腔内修复术后内漏的诊断与治疗 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(6): 636-637.
4. Chalmers N, Eadington DW, Gandanhamo D, et al. Case report: infected false aneurysm at the site of an iliac stent [Ｊ]. Br J Radiol, 1993; 66(790): 946-948.
5. 施德兵, 符伟国, 王玉琦, 等. 合并马凡综合征的破裂腹主动脉瘤腔内治疗术后并发感染 [Ｊ]. 中国实用外科杂志, 2006; 26(5): 391-394.
6. Fu WG, Shi DB, Wang YQ, et al. Aortic stent graft infection in a patient with Marfan syndrome [Ｊ]. Chin Med J (Engl), 2007; 120(10): 935-937.
7. Silberfein EJ, Lin PH, Bush RL, et al. Aortic endograft infection due to Pasteurella multocida following a rabbit bite [Ｊ]. J Vasc Surg, 2006; 43(2): 393-395.
8. Ducasse E, Calisti A, Speziale F, et al. Aortoiliac stent graft infection: current problems and management [Ｊ]. Ann Vasc Surg, 2004; 18(5): 521-526.
9. Fiorani P, Speziale F, Calisti A, et al. Endovascular graft infection: preliminary results of an international enquiry [Ｊ]. J Endovasc Ther, 2003; 10(5): 919-927.
10. Heyer KS, Modi P, Morasch MD, et al. Secondary infections of thoracic and abdominal aortic endografts [Ｊ]. J Vasc Interv Radiol, 2009; 20(2): 173-179.
11. Zetrenne E, McIntosh BC, McRae MH, et al. Prosthetic va-scular graft infection: a multi-center review of surgical management [Ｊ]. Yale J Biol Med, 2007; 80(3): 113-121.
12. Sharif MA, Lee B, Lau LL, et al. Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair [Ｊ]. J Vasc Surg, 2007; 46(3): 442-448.
13. Parsons RE, Sanchez LA, Marin ML, et al. Comparison of endovascular and conventional vascular prostheses in an experimental infection model [Ｊ]. J Vasc Surg, 1996; 24(6): 920-925; discussion 925-926.
14. Speziale F, Calisti A, Zaccagnini D, et al. The value of technetium-99m HMPAO leukocyte scintigraphy in infectious abdominal aortic aneurysm stent graft complications [Ｊ]. J Vasc Surg, 2002; 35(6): 1306-1307.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Management of Aortic Stent Graft Infection (Report of 4 Cases)

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