Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists · 2015
Late Conversion After Sac Anchoring Endoprosthesis for Secondary Aortic Aneurysm Infection.
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Tolenaar Jip L, van den Ham Leo H, Reijnen Michel M P J, de Vries Jean-Paul P M
Аннотация
PURPOSE: To demonstrate explantation of the Nellix Endovascular Aneurysm Sealing (EVAS) System in the setting of infection.
CASE REPORTS: Two male patients, 71 and 83 years old, underwent Nellix implantation for asymptomatic infrarenal aortic aneurysms measuring 5.1 and 6.3 cm, respectively. Each developed late infections at 8 and 4 months post EVAS, respectively. The first patient experienced aneurysm rupture after medical therapy failed; the Nellix endosystem was explanted in an uneventful procedure. The second patient developed an aortoduodenal fistula, which was sutured before the Nellix device was removed without complications. The patient died 3 months later, presumably due to ongoing infection.
CONCLUSION: The need to explant a Nellix EVAS System due to graft infection is a straightforward procedure compared to the removal of a conventional endograft with suprarenal fixation. It requires only temporary suprarenal clamping. The devices can be easily removed due to the lack of penetrating components and without damage to the aortic segment needed to create an anastomosis.
CASE REPORTS: Two male patients, 71 and 83 years old, underwent Nellix implantation for asymptomatic infrarenal aortic aneurysms measuring 5.1 and 6.3 cm, respectively. Each developed late infections at 8 and 4 months post EVAS, respectively. The first patient experienced aneurysm rupture after medical therapy failed; the Nellix endosystem was explanted in an uneventful procedure. The second patient developed an aortoduodenal fistula, which was sutured before the Nellix device was removed without complications. The patient died 3 months later, presumably due to ongoing infection.
CONCLUSION: The need to explant a Nellix EVAS System due to graft infection is a straightforward procedure compared to the removal of a conventional endograft with suprarenal fixation. It requires only temporary suprarenal clamping. The devices can be easily removed due to the lack of penetrating components and without damage to the aortic segment needed to create an anastomosis.
Предметные рубрики MeSH
AgedAged, 80 and overAortic Aneurysm, AbdominalAortographyBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationConstrictionDevice RemovalEndovascular ProceduresFatal OutcomeHumansMalePositron-Emission TomographyProsthesis-Related InfectionsReoperationSuture TechniquesTime FactorsTomography, X-Ray ComputedTreatment Outcome