Explantation of an Infected Fenestrated Abdominal Endograft with Autologous Venous Reconstruction

Abstract

Introduction

Infectious complications after FEVAR cause significant problems, with radical surgery considered to be the last resort for treatment.

Case report

A 72 year old man presented with infection 1 month after FEVAR. Conservative therapy with percutaneous abscess drainage and antibiotics suppressed the infection for 10 months; however, when new peri-aortic abscesses developed, the patient agreed to revision surgery. The endograft was explanted and an autologous in situ venous reconstruction was performed. As a result of post-operative complications, the patient died 3 days later.

Conclusion

This study demonstrates that autologous venous reconstruction is technically feasible. An earlier decision on such radical surgery could potentially have improved the patient's chances of survival.

Highlights

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  Infection of a fenestrated abdominal endograft causes a major problem with high morbidity and mortality rates.

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  Explantation of the endograft with autologous venous reconstruction is technically feasible.

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  Earlier decision for radical surgery could potentially improve survival rates.