“
TL;DR
The authors report that total endograft explantation with in situ aortic reconstruction using autogenous or biological grafts is the optimal surgical management strategy.
Vascular Specialist International · 1 author, 1 centre
This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.
The authors report that total endograft explantation with in situ aortic reconstruction using autogenous or biological grafts is the optimal surgical management strategy.
AEI is reported to occur in 0.6% of cases after EVAR, with a range of 0.2% to 8%. Positive cultures from percutaneous or intraoperatively obtained specimens serve as the reference standard, though prior antibiotic use may yield negative cultures. Treatment has three components: antimicrobial therapy, endograft removal with debridement, and arterial flow restoration. Surgical explantation is associated with high mortality of 18%–30%. Current practice favors in situ aortic reconstruction over extra-anatomic bypass, with SVS and AHA guidelines recommending extra-anatomic bypass only in cases with extensive contamination or multidrug-resistant organisms. Conservative treatment is an alternative for high surgical risk patients.