CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2017; 06(01): e32-e34
DOI: 10.1055/s-0037-1607272
Case Report: Vascular
Georg Thieme Verlag KG Stuttgart · New York

Ascendobifemoral Bypass for the Treatment of a Thoracic Endograft Infection

Sebastian Paul Pleger
1   Department of Vascular and Endovascular Surgery, Jung-Stilling Hospital, Siegen, Germany
,
Nadine Nink
1   Department of Vascular and Endovascular Surgery, Jung-Stilling Hospital, Siegen, Germany
,
Andreas Böning
2   Department of Adult and Pediatric Cardiovascular Surgery and Vascular Surgery, University Hospital of Giessen, Justus Liebig University, Giessen, Germany
,
Ahmed Koshty
1   Department of Vascular and Endovascular Surgery, Jung-Stilling Hospital, Siegen, Germany
› Author Affiliations
Further Information

Publication History

14 June 2017

05 September 2017

Publication Date:
09 October 2017 (online)

Abstract

Background Endograft infections (EIs) are rare complications after endovascular procedures in the thoracic and abdominal aortas. The challenging treatment encloses antibiotic and surgical therapies.

Case Description A 74-year-old male patient developed an EI after an endovascular procedure (thoracic endovascular aortic repair [TEVAR]). Despite a long-term oral antibiotic therapy, the clinical symptoms showed no falling trend. Because of the expanded infection from above the celiac trunk up to the aortic arch, we decided to remove the infected endograft and to implant an extra-anatomic ascendobifemoral bypass.

Conclusion The implantation of an ascendobifemoral bypass was a successful treatment option for EIs after TEVAR.

 
  • References

  • 1 Cernohorsky P, Reijnen MM, Tielliu IF, van Sterkenburg SM, van den Dungen JJ, Zeebregts CJ. The relevance of aortic endograft prosthetic infection. J Vasc Surg 2011; 54 (02) 327-333
  • 2 Evangelista A, Czerny M, Nienaber C. , et al. Interdisciplinary expert consensus on management of type B intramural haematoma and penetrating aortic ulcer. Eur J Cardiothorac Surg 2015; 47 (02) 209-217
  • 3 Fatima J, Duncan AA, de Grandis E. , et al. Treatment strategies and outcomes in patients with infected aortic endografts. J Vasc Surg 2013; 58 (02) 371-379
  • 4 Smeds MR, Duncan AA, Harlander-Locke MP. , et al; Vascular Low-Frequency Disease Consortium. Treatment and outcomes of aortic endograft infection. J Vasc Surg 2016; 63 (02) 332-340
  • 5 Heyer KS, Modi P, Morasch MD. , et al. Secondary infections of thoracic and abdominal aortic endografts. J Vasc Interv Radiol 2009; 20 (02) 173-179
  • 6 Murphy EH, Szeto WY, Herdrich BJ. , et al. The management of endograft infections following endovascular thoracic and abdominal aneurysm repair. J Vasc Surg 2013; 58 (05) 1179-1185
  • 7 Said SM, Burkhart HM, Dearani JA, Connolly HM, Schaff HV. Ascending-to-descending aortic bypass: a simple solution to a complex problem. Ann Thorac Surg 2014; 97 (06) 2041-2047 , discussion 2047–2048
  • 8 Oderich GS, Bower TC, Cherry Jr KJ. , et al. Evolution from axillofemoral to in situ prosthetic reconstruction for the treatment of aortic graft infections at a single center. J Vasc Surg 2006; 43 (06) 1166-1174
  • 9 Kumar MV, Choudhary SK, Talwar S. , et al. Extraanatomic bypass to supraceliac abdominal aorta for complex thoracic aortic obstruction. Ann Thorac Surg 2016; 101 (04) 1552-1557