Endovascular treatment for primary infected aortic aneurysms: single center 8-year experience

Abstract

To assess the efficacy and outcome of endovascular aortic repair (EVAR) for the treatment of primary infected aortic aneurysms (PIAAs). Methods The clinical data of 15 consecutive patients presenting with PIAA from Apr 2010 to Apr 2018 were retrospectively reviewed. Results 10 were male out of 15 patients ranging from 55 to 80 years old.The aneurysms were located in thoracoabdominal aorta in 1 case, abdominal aorta in 10 cases and left common iliac artery in 4 cases. Positive microbial cultures were reported in 13 patients, including Salmonella species in 12 and Streptococcus in 1. Eleven patients received preoperative antibiotics therapy before elective EVAR for more than 1 week. Four patients underwent emergency EVAR due to ruptured aneurysms. Postoperative antibiotic therapy was given for at least six months.There was no death within 30 days. Mean follow-up time was 44.6 months.Infection relapsed in 6 patients during follow-up. Infection-related death occurred in 3 cases.3 of them were healed. Conclusions EVAR combined with aggressive antibiotic strategy is feasible for the treatment of PIAAs, particularly in high-risk surgical patients or in the acute setting of rupture. Key words: Aortic aneurysm; Infection; Endovascular aneurysm repair